Pharmacokinetics of high-dose extended-infusion meropenem during pulmonary exacerbation in adult cystic fibrosis patients: a case series

New Microbiol. 2018 Jan;41(1):47-51. Epub 2018 Jan 9.


This case series explored the pharmacokinetic/pharmacodynamic (PK/PD) characteristics of meropenem (MEM) in adult cystic fibrosis (CF) patients hospitalized for a pulmonary exacerbation. From January 2015 to June 2016, all adult patients with cystic fibrosis (CF) and chronic pulmonary infection due to meropenem (MEM)-susceptible/intermediate Pseudomonas aeruginosa who received at least 48 h of MEM as an extended 3-hour infusion for treating a pulmonary exacerbation were enrolled. MEM plasma concentrations were determined by high-performance liquid chromatography. Six adult CF patients with a median age of 47 years were included in the study. MEM showed a high Vd (mean 45.98 L, standard deviation [SD] ±34.45). A minimal PK/PD target of 40% T > minimum inhibitory concentration (MIC) with respect to the MEM MIC of P. aeruginosa strains isolated from sputum during exacerbation was achieved in 5/6 patients (83%). MEM failed to achieve this target only in one patient, whose strain showed the highest MEM MIC in our cohort (8 mg/L). In all patients, MEM was well tolerated, and no adverse events were reported. In conclusion, high-dose, extended-infusion MEM during pulmonary exacerbation showed a high Vd in six adult CF patients with high median age, and was well tolerated.

Keywords: Cystic fibrosis; Meropenem; Pharmacokinetic; Therapeutic drug monitoring.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / pharmacokinetics
  • Anti-Bacterial Agents / therapeutic use
  • Cystic Fibrosis / drug therapy*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Resistance, Bacterial
  • Female
  • Humans
  • Male
  • Meropenem
  • Microbial Sensitivity Tests
  • Middle Aged
  • Pseudomonas Infections / blood
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas aeruginosa / drug effects
  • Thienamycins / administration & dosage
  • Thienamycins / blood
  • Thienamycins / pharmacokinetics*
  • Thienamycins / therapeutic use*


  • Anti-Bacterial Agents
  • Thienamycins
  • Meropenem