Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: Results from a guideline-based performance improvement program. A meta-analysis of individual patient data from randomized trials. Continuous versus intermittent β-lactam infusion in severe sepsis. Ticagrelor was recently approved for clinical use in ACS patients, at a dose of 180 mg loading dose and 90 mg twice/day maintenance dose. Interrelationship between pharmacokinetics and pharmacodynamics in determining dosage regimens for broad-spectrum cephalosporins. Ticagrelor is a reversible direct acting P2Y12 antagonist, which has shown to be superior to clopidogrel, in adjunct to aspirin, in preventing recurrent ischemic events, including cardiovascular mortality. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Meropenem: A review of its use in the treatment of serious bacterial infections. We recommend the administration of a loading dose of 0.5 g meropenem over 30 min immediately followed by continuous infusion.īaldwin CM, Lyseng-Williamson KA, Keam SJ. Higher loading doses did not lead to further improvements of target attainment. If all three covariates showed extreme values (= worst-case scenario), a loading dose of 0.5 g was necessary. A maximum loading dose of 0.33 g resulted in sufficient plasma concentrations when only one covariate showed extreme values. Low albumin concentrations, high body weight and high creatinine clearances increased the required loading dose.

Dosing regimens were considered adequate if the 5th percentile of the concentration-time profile did not drop at any time below four times the S/I breakpoint (= 2 mg/L) of Pseudomonas aeruginosa according to the EUCAST definition. In addition to the examination of the influence of individual covariates, a best-case and worst-case scenario were simulated. Maintenance doses administered as continuous infusion of 1.5-6 g/24 h with preceding loading doses (administered as 30 min infusion) of 0.15-2 g were investigated. A previously published and successfully evaluated pharmacokinetic model of critically ill patients was used for stochastic simulations of virtual patients. The aim of this study was to investigate optimal loading doses prior to continuous infusion of meropenem in critically ill patients.

Loading dose