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Simulation-based Antibiotic Treatment: Meropenem Administration for Elderly Pneumonia Patients

Kouji Aimiya, Takayoshi Mamiya, Katsunori Tabuchi, Toshiyuki Kita and Masayuki Hiramatsu, Japan

Meropenem (MEPM) is a carbapenem antimicrobial used for the treatment of pneumonia. Our previous study revealed that there are no differences on the therapeutic effects of MEPM (0.5 g) between the treatment of twice daily and three-times daily for the elderly pneumonia patients(?75 years old). However, it is unclear what factor significant are for the elderly pneumonia patients.In this study, the MEPM concentration in the blood was simulated by pharmacokinetics/pharmacodynamics (PK/PD)theory, we estimated the effective number of MEPM administration, and then we evaluated the therapeutic effects. Two elderly patients, who are diagnosed moderate pneumonia patients in our hospital were simulated using the factors, age, sex, body weight and serum creatinine values. It was expected to be effective by the PK/PD-based simulation; MEPM treatment twice daily in one case, and three-times daily in other case. Actually, both administrations improved the body temperature, white blood cell and C-reactive protein (CRP), indicating that appropriate treatment of MEPM may prevent the worsening of symptom. These results suggest that it would be very significant to treat the pneumonia patients carefully by considering renal function and conducting the simulations of antimicrobial drugs based on the PK-PD theory.

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