BACKGROUND: Gram-negative bacteria are associated with significant morbidity and mortality in preterm and term newborns. Meropenem has widespread
efficacy and often allows for monotherapy in this group. Prolonged infusion instead of infusion over 30 minutes has been suggested to result in higher microbiologic efficacy.
OBJECTIVE: To compare the clinical and microbiologic efficacy and safety of prolonged infusions versus conventional dosing of meropenem in neonates with Gram negative late onset sepsis (GN-LOS).
METHODS: A prospective, randomized, clinical trial was conducted in neonates with GN-LOS admitted to NICU, Mansoura University Children’s Hospital between August 2013 to June 2015.
A total of 102 infants (51 in each group) were recruited. The infusion group demonstrated a significantly higher rate of clinical improvement and microbiological eradication at 7 days after starting meropenem therapy compared to the conventional group. Mortality and duration of RS were significantly less in the infusion group compared with conventional group. Acute kidney injury (AKI) after meropenem treatment was significantly less in the infusion group compared with the conventional group.
CONCLUSIONS: Prolonged infusion of meropenem in neonates with GN-LOS is associated with higher clinical improveme
nt, microbiologic eradication, less neonatal mortality, shorter duration RS and less AKI compared with the conventional strategy