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Article
Success With Extended-Infusion Meropenem After Recurrence of Baclofen Pump-Related Achromobacter Xylosoxidans Meningitis in an Adolescent
Journal of Pharmacy Practice
  • Kristen R. Nichols, Butler University
  • Chad A. Knoderer, Butler University
  • Nicholas G. Jackson, Butler University
  • John J. Manaloor
  • John C. Christenson
Document Type
Article
Publication Date
1-1-2015
DOI
http://dx.doi.org/10.1177/0897190015585757
Abstract

A 13-year-old female experienced a recurrence of baclofen pump-related central nervous system (CNS) infection caused by Achromobacter, despite absence of retained foreign material. Due to the failure of meropenem (120 mg/kg/d in divided doses every 8 hours and infused over 30 minutes) in the initial infection, the dose was infused over 4 hours during the recurrence. Meropenem is an antibiotic for which efficacy is time dependent, and 4-hour versus 30-minute infusions have been shown to prolong the time the concentration of the antibiotic exceeds the minimum inhibitory concentration (MIC) of the organism at the site of infection (T>MIC). Meropenem serum concentrations were obtained and indicated that T>MIC was at least 75% of the dosing interval. Our patient improved with no noted recurrences or adverse effects on the extended-infusion meropenem regimen. Utilization of extended-infusion beta-lactam dosing whenever possible in the treatment of serious infections caused by gram-negative organisms should be considered, as this dosing appears to be safe and improves the probability of achieving pharmacokinetic/pharmacodynamic goals.

Rights

This is a post-print version of an article originally published in [Journal Name], 2015, Volume 28, Issue 4.

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The version of record is available through: Sage.

Citation Information
Kristen R. Nichols, Chad A. Knoderer, Nicholas G. Jackson, John J. Manaloor, et al.. "Success With Extended-Infusion Meropenem After Recurrence of Baclofen Pump-Related Achromobacter Xylosoxidans Meningitis in an Adolescent" Journal of Pharmacy Practice Vol. 28 Iss. 4 (2015) p. 430 - 433
Available at: http://works.bepress.com/kristen_nichols/17/