FACTORS AFFECTING MEROPENEM TROUGH LEVELS IN CRITICALLY ILL PATIENTS: A THERAPEUTIC DRUG MONITORING STUDY

Objective: This study primarily aimed to determine meropenem the trough level (Cmin) in intensive care unit (ICU), with an exploratory secondary aim of evaluating factors influencing Cmin and clinical cure.Material and Method: This prospective study included adult ICU patients receiving meropenem for ≥48 hours, and Cmin levels were measured using a ready-to-use ELISA kit.Result and Discussion: The study included 38 patients, 26 of whom were male. Mean meropenem Cmin value was found to be 0.40 ± 0.07 mg/l which is statistically different than the target value of 8 mg/l (p < 0.001). We found no statistically significant difference in mean Cmin between the patient groups whose creatinine clearance was smaller than 50 ml/min and not. Erythrocyte and hemoglobin values decreased after meropenem treatment compared to baseline (p < 0.05). C-Reactive Protein (CRP) decreased, and Sequential Organ Failure Assessment (SOFA) values increased after meropenem treatment (p < 0.001). Logistic regression in patients with Systemic Inflammatory Response Syndrome (SIRS) showed that only SOFA reduced the clinical cure rate (OR 0.534, 95% CI 0.311–0.917). In this study, the target 100% fT > MIC < 4×MIC was not achieved with standard or extended meropenem infusion, potentially limiting clinical cure in ICUs with resistant pathogens, highlighting the need for alternative dosing strategies.