The effect of continuous infusion of meropenem antibiotic on clinical signs and changes of procalcitonin in patients with acute sepsis related to cancer

Abstract

Author(s): Javad Farokhi, Alireza Kamali, Nader Zarrinfar, Behnam Mahmodiyeh*, Bijan Yazdi and Mohammad Jamalian

Introduction: Infections in critically ill immunocompromised patients with cancer are related to different diagnostic and therapeutic challenges. Sepsis, severe sepsis, and septic shock are used to describe the body's systemic response to aggressive microorganisms, including bacteria and fungi. The aim of the present study was to evaluate the effect of continuous infusion of meropenem antibiotics on clinical signs and changes of procalcitonin in patients with acute sepsis.

Material and Methods: This study is a double-blind randomized clinical trial. The number of patients in each group was 30. In the infusion group, they received 1 gram of meropenem as a bolus and 100 mg (10 ml) of meropenem per hour of continuous intravenous infusion over a 72-hour period. Patients in the bolus group received one gram of meropenem as a bolus, followed by a bolus dose every 12 hours, as well as a placebo infusion of 10 ml/h for 72 hours. Patients' clinical symptoms including fever, hypertension, heart rate, respiratory rate, the severity of the disease, drug sensitivity, and level of consciousness at admission were recorded 24, 48 and 72 hours after drug administration. Data were analyzed by SPSS v19.

Results: There was a significant decrease in temperature in the infusion group 24, 48 and 72 hours after treatment (p<0.05). In the infusion group the heart rate was lower (p=0.001). The severity of the disease was better in the infusion group (p<0.05). The level of consciousness was better in the infusion group (p<0.05). 72 hours after treatment there was a statistically significant difference in white blood cell count (p<0.05). In the infusion group after 72 hours, the APACHE score was lower than in the bolus group (p<0.05).

Conclusion: The infusion group showed lower temperature, lower heart rate, higher consciousness, disease severity, and lower APACHE score.

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