Usage of Meropenem Continuous Infusion for treatment of Sepsis in Geriatric Patients in Trauma and Orthopaedics. A case series

Background Prolonged infusion of meropenem is recommended by guidelines for the treatment of sepsis. However, the use of prolonged infusions of meropenem is not registered by the FDA and is considered an off-label application. Also, some studies provide controversial data on the advantage of prolonged infusions over intermittent ones. It is known that age is an independent predictor of mortality in patients with sepsis and septic shock. In this study, we evaluated the effectiveness of continuous infusion in geriatric trauma patients with sepsis. This was a single-center case series of 7 geriatric trauma patients with sepsis who received continuous infusion of meropenem from November 2021 to March 2023. The objective of this study is to evaluate the feasibility and clinical impact of continuous infusion of meropenem in elderly with sepsis. Data including clinical findings, laboratory data, complications, and survival to hospital discharge were also collected. 7 patients (median age 71, 100% female) received continuous infusion of meropenem. All patients were septic prior to infusion. 1 patient transferred to another hospital and died during hospitalization, 6 survived to hospital discharge and 1 patient died after discharge. Multiresistant bacteria were observed in 2 patients. Conclusion. The use of continuous infusion of meropenem can lead to clinical improvement, but do not decrease death rate. Keywords: Sepsis, meropenem continuous infusion, geriatric trauma, SIRS, a case report.