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Meropenem Clinical Pharmacokinetics

 

作者: Johan W. Mouton,   John N. van den Anker,  

 

期刊: Clinical Pharmacokinetics  (ADIS Available online 1995)
卷期: Volume 28, issue 4  

页码: 275-286

 

ISSN:0312-5963

 

年代: 1995

 

出版商: ADIS

 

数据来源: ADIS

 

摘要:

Meropenem is a recently developed carbapenem antibiotic, similar to imipenem, with a wide spectrum of activity against Gram-positive and Gramnegative bacteria. In comparison with imipenem, meropenem is relatively stable to hydrolysis by the enzyme dehydropeptidase I (DHP-I), thus precluding the need for coadministration with an inhibitor of DHP-I, such as cilastatin. Furthermore, meropenem may be less nephrotoxic and neurotoxic than imipenem.Plasma meropenem concentrations reach a peak (Cmax) of approximately 30 mg/L after administration of a standard dose of 1g intravenously. The elimination half-life (t½) is approximately 1 hour, and the area under the plasma concentration-time curve increases linearly in a dose-related manner.The volume of distribution is 21L, indicating predominantly extracellular distribution. Meropenem distributes partly into cerebrospinal fluid. The drug is eliminated both by metabolism and excretion. In normal volunteers, up to 70% is recovered in urine, and the remainder is accounted for by a &bgr;-lactam ring-opened form of the compound, ICI 213689.The t½of meropenem is prolonged in patients with renal insufficiency and correlates well with creatinine clearance. Dosage adjustments in people with decreased creatinine clearance can, thus, be made on the basis of creatinine clearance.

 

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