Publication: Predictors and outcomes of meropenem treatment failure among patients with septic shock in the intensive care unit
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Date
2021
Authors
Ghazali, Amar Ghassani
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Abstract
Background Recently, the inappropriate used of meropenem in critically ill patient were increased. Thus, increased development of drug resistance bacteria towards meropenem. Therefore, this study evaluated the appropriate use of meropenem and determined the predictors of meropenem treatment failure as well as the patient outcomes. Methods This was a retrospective, cohort study, involving patients who were admitted to medical and surgical ICU HUSM since 1st January 2016 until 1st June 2019 and were diagnosed as septic shock, then started on IV meropenem The cases were divided into 2 groups. Treatment success is defined as resolved fever, reduced total white cell (TWC), reduced c-reactive protein (CRP) and subsequent culture and sensitivity sampling negative Results A total of 354 patients were recruited. Most patient were male. A 50 patient were not responded to treatment. The mean age was 54.7 (SD = 17.87). Among all the studied factors, only APCHE mean 25.22 (SD = 6.85) and SOFA 8.74 (SD = 4.82) were found to be independently associated with treatment failure. The higher risk of mortality was observed among patients with higher APACHE, SOFA score and with antibiotics >72 hours (adjusted OR = 1.21; 95% CI: 1.12, 1.30; P<0.001), (adjusted OR = 1.23; 95% CI: 1.08, 1.41; P<0.001), and (adjusted OR = 6.38; 95% CI: 1.67, 24.50; P=0.007). Besides that, treatment failure chances were equal to 1 for those who received meropenem less than 5 days Conclusion A total of 50 (14.12%) patient had a treatment failure with meropenem. The predictors of meropenem failure were higher APACHE and SOFA score.
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Keywords
Meropenem failures , sepsis