Comparison of the pharmacodynamics of imipenem in patients with ventilator-associated pneumonia following administration by 2 or 0.5 h infusion


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Abstract

ObjectivesThe aim of this study was to compare the t > MICs of imipenem between administration by a 2 h infusion with a 0.5 h infusion.MethodsThe study was a randomized three-way crossover in nine patients with ventilator-associated pneumonia. Each subject received imipenem in three regimens consecutively: (i) a 0.5 h infusion of 0.5 g every 6 h for 24 h; (ii) a 2 h infusion of 0.5 g every 6 h for 24 h; and (iii) a 2 h infusion of 1 g every 6 h for 24 h.ResultsFollowing the 0.5 h infusion of 0.5 g of imipenem, the percentages of the t > 4 × MICs of 4, 2 and 1 mg/L were 20.32 ± 9.32%, 44.11 ± 16.40% and 64.67 ± 20.56% of a 6 h interval, respectively. For the 2 h infusion of 0.5 g of imipenem, the percentages of the t > 4 × MICs of 4, 2 and 1 mg/L were 17.71 ± 19.27%, 53.75 ± 19.30% and 76.54 ± 17.36% of a 6 h interval, respectively. For the 2 h infusion of 1 g of imipenem, the percentages of the t > 4 × MICs of 4, 2 and 1 mg/L were 60.26 ± 23.96%, 77.78 ± 20.11% and 93.35 ± 8.26% of a 6 h interval, respectively.ConclusionsThe 2 h infusions of imipenem resulted in greater t > MICs than the 0.5 h infusion. For infections caused by pathogens with high MICs, a 2 h infusion of 1 g of imipenem every 6 h can provide plasma concentrations above the MIC of 4 mg/L for 60% of a 6 h interval.

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