Population Pharmacokinetic Analysis of Meropenem After Intravenous Infusion in Korean Patients With Acute Infections

Purpose: The aim of this study was to investigate the population pharmacokinetic (PK) profile of meropenem in Korean patients with acute infections. Methods: The study included 37 patients with a creatinine clearance <= 50 or >50 mL/min who received a 500- or 1000-mg dose of meropenem, respectively, infused intravenously over 1 hour every 8 hours. Blood samples were collected before and at 1, 1.5, and 5 hours after the start of the fourth infusion. The population PK analysis was conducted by using nonlinear mixed effect modeling software (NONMEM). Monte-Carlo simulations were performed to identify optimal dosing regimens. Findings: Thirty-seven subjects completed the study. Meropenem PK variables were well described by using a one-compartment model. The typical values (relative SE) for weight-normalized clearance (CL) and V-d were 0.266 Lh/kg (12.29%) and 0.489 L/kg (11.01%), respectively. Meropenem CL was significantly influenced by the serum creatinine level, which explained 11% of the interindividual CK variability. The proposed equation to estimate meropenem CL in Korean patients was as follows: CL (L/h) = 0.266 x weight x [serum creatinine/0.74](-1.017). The simulation results indicate that the current meropenem dosing regimen may be suboptimal in patients infected with normal or augmented renal function. (C) 2018 Published by Elsevier Inc.