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Journal of Antimicrobial Chemotherapy (2000) 45, 247-250
© 2000 The British Society for Antimicrobial Chemotherapy

Brief reports

Use of meropenem 3 g once daily for outpatient treatment of infective exacerbations of bronchiectasis

Elizabeth S. R. Darleya,*, Karen E. Bowkera, Andrew M. Loveringa, John E. Harveyb and Alasdair P. Macgowana

a Bristol Centre for Antimicrobial Research and Evaluation, North Bristol NHS Trust and University of Bristol, Department of Medical Microbiology, and b Department of Respiratory Medicine, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK

Meropenem administered as a single iv 3 g dose once every 24 h was used to treat nine ambulatory patients with infective exacerbations of bronchiectasis. Serum meropenem concentrations were measured before dosing and at 30 min after each 30 min infusion. Mean pre-dose concentrations were <0.1 mg/L and mean post-dose concentrations 93.9 ± 29.5 mg/L (95% confidence interval (CI) 86.2–101.6, n = 59). A pathogen was cultured from sputum in six patients and eradicated (<100 cfu/g sputum) in all but one by day 6 of therapy. Previous work on animals has shown that a bacteriostatic effect is seen with meropenem when t > MIC is greater than 20–30% of the dose interval. In these nine patients, this could be achieved and was associated with successful outcome for pathogens for which MICs are <= 0.5 mg/L. Therefore, once-a-day meropenem therapy may be a useful option for outpatient treatment for isolates for which MICs are <= 0.5 mg/L.

* Corresponding author. Tel: +44-117-959-5651; Fax: +44-117-959-3154.


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