Population pharmacokinetics of meropenem in patients undergoing automated peritoneal dialysis

Sami Ullah, Martin Ursli, Uwe Fuhr, Martin Wiesholzer, Manuel Kussmann, Wolfgang Poeppl, Markus Zeitlinger, Max Taubert

Publikation: Beitrag in Fachzeitschrift (peer-reviewed)Artikel in Fachzeitschrift


BACKGROUND: Meropenem is a second-line agent for the treatment of peritoneal dialysis-associated peritonitis (PD peritonitis), while information on pharmacokinetics (PK) of intraperitoneal (i.p.) meropenem is limited in this patient group. The objective of the present evaluation was to assess a pharmacokinetic rationale for the selection of meropenem doses in automated PD (APD) patients based on population PK modelling.

METHODS: Data were available from a PK study in six patients undergoing APD who received a single 500 mg dose of meropenem intravenous or i.p. A population PK model was developed for plasma and dialysate concentrations (n = 360) using Monolix. Monte Carlo simulations were carried out to assess the probability of achieving meropenem concentrations above minimum inhibitory concentrations (MICs) of 2 and 8 mg/L, representing susceptible and less susceptible pathogens respectively, for at least 40% of the dosing interval (T >MIC ≥ 40%).

RESULTS: A two-compartment model for each plasma and dialysate concentrations with one transit compartment for the transfer from plasma to dialysate fluid described the data well. An i.p. dose of 250 and 750 mg, for an MIC of 2 and 8 mg/L respectively, was sufficient to attain the pharmacokinetic/pharmacodynamic target (T >MIC ≥ 40%) in more than 90% patients in plasma and dialysate. Additionally, the model predicted that no relevant meropenem accumulation in plasma and/or peritoneal fluid would occur with prolonged treatment.

CONCLUSION: Our results suggest that an i.p. dose of 750 mg daily is optimal for pathogens with an MIC 2-8 mg/L in APD patients.

Seiten (von - bis)402-410
FachzeitschriftPeritoneal Dialysis International
Frühes Online-Datum02 Mai 2023
PublikationsstatusVeröffentlicht - Sept. 2023


Untersuchen Sie die Forschungsthemen von „Population pharmacokinetics of meropenem in patients undergoing automated peritoneal dialysis“. Zusammen bilden sie einen einzigartigen Fingerprint.

Dieses zitieren