关键词:

肾功能亢进, 美罗培南, 日剂量, 临床疗效

Abstract:

Objective　To explore the clinical efficacies of different daily doses of meropenem in patients with hyperactive renal function. Methods　A retrospective analysis was conducted on 144 patients treated with meropenem at Dongying Second People's Hospital from January 2021 to December 2022. Based on the creatinine clearance rate (CCr), the patients were divided into a hyperactive renal function group (63 cases) and a normal renal function group (81 cases). In the hyperactivity group, there were 37 males and 26 females, aged 37-69 (53.55±4.47) years, with a body mass of 46-93 (71.51±6.06) kg, with a disease course of 1-6 (2.98±0.93) years. In the normal group, there were 48 males and 33 females, aged 41-73 (53.50±4.42) years, with a body weight of 49-89 (71.56±6.01) kg, with a disease course of 1-5 (2.97±0.95) years. The renal function [Ccr, serum creatinine (Scr), and blood urea nitrogen (BUN)], inflammatory indicators [white blood cell count (WBC), neutrophil percentage (NEUT%), procalcitonin (PCT), and C-reactive protein (CRP)], medication status, and clinical efficacy of different daily doses of meropenem were compared between the two groups. Independent sample t test and χ² test were used. Results　The Ccr level in the hyperactivity group was higher than that in the normal group [(126.14±11.63) ml/min vs. (116.25±10.51) ml/min], but the levels of Scr [(47.66±4.25) μmol/L] and BUN [(3.10±0.33) mmol/L] were lower than those in the normal group [(58.62±5.62) μmol/L and (4.22±0.49) mmol/L], with statistically significant differences (all P<0.05). The levels of WBC [(15.55±1.23) ×10⁹/L], NEUT% [(77.85±5.69)%], PCT [(48.60±4.12) µg/L], and CRP [(16.17±3.55) mg/L] in the hyperactivity group were higher than those in the normal group [(9.44±1.56) ×10⁹/L, (68.52±5.52)%, (48.60±4.12) µg/L, and (9.23±1.06) mg/L], with statistically significant differences (all P<0.05). The drug use of the hyperactivity group was higher than that of the normal group at 0.5 g dose (administered every 6 h and every 8 h) and 2.0 g dose (administered every 8 h), but lower than that of the normal group at 1.0 g dose (administered every 8 h and every 12 h), with statistically significant differences (all P<0.05). The clinical effective rates of the hyperactivity group at 1/2 day dose and 2/3 day dose were 0 (0/15 and 0/17), which were lower than those of the normal group [88.89% (8/9) and 92.31% (24/26)], with statistically significant differences (both P<0.05). The clinical effective rate of the hyperactivity group at 1 day dose [50.00% (10/20)] was higher than those at 1/2 day dose and 2/3 day dose, but still lower than that of the normal group [75.61% (31/41)], with statistically significant differences (all P<0.05). The clinical effective rate of the hyperactivity group at double daily dose was 81.82% (9/11), without statistically significant difference compared with 100.00% (5/5) of the normal group (P>0.05). Conclusions　Different doses of meropenem affect the clinical efficacy in patients with hyperactive renal function. The dosage should be ≥ 2.0 g (daily dose), and can be increased to 3.0 g if necessary.

Key words:

Hyperactive renal function, Meropenem, Daily dose, Clinical efficacy