Cross Sectional Survey on Therapeutic Drug Monitoring of Imipenem in Critically Ill Patients of the Real World / 中国药学杂志

ABSTRACT

OBJECTIVE: To explore the application of therapy drug monitoring of imipenem in ICU, and to provide evidence for the use of imipenem in critically ill patients. METHODS: A cross-sectional survey was conducted to collect clinical data of 67 patients receiving therapeutic drug monitoring of imipenem in ICU from January 1, 2016 to December 31, 2018. Using SPSS21.0 statistical software, 71 cases of therapeutic drug monitoring data (blood drug concentration, f%T>MIC) and related clinical data were analyzed. RESULTS: Of all 71 cases of therapeutic drug monitoring, there are 37 cases (52.11%) f%TMIC≥40%,26 cases(36.62%)f%TMIC70%,and 10 cases(14.08%) f%TMIC=100%. f%TMIC of all cases with 0.25 g q6h were 70%. Among other dosage regimens, the highest proportion of f%T>MIC>40% was 1 g q12h (66.67%) and the highest proportion of f%T>MIC>70% was 0.5 g q8h(43.59%). According to different f%T>MIC, those patients were divided into ≤40% group, >40%-70% group and>70%group. Only group>70% showed a downward trend in the infection index of patients before and after medication. The body temperature decreased significantly (P=0.004), while the average PCT level of group MIC>70% group showed a downward trend in serum creatinine after treatment, but there was no significant difference (P=0.285). The serum drug concentration in CRRT group was slightly higher than that in non-CRRT group, and there was no significant difference in f%T>MIC (P=0.376, P=0.209, P=0.988). CONCLUSION: The level of f%T>MIC of imipenem in ICU is unsatisfactory. For critically ill patients, when imipenem f%T>MIC>70%, the antimicrobial effect is better.