Pharmacokinetics/Pharmacodynamics Of Meropenem In Plasma And Cerebrospinal Fluid In Patients With Intraventricular Hemorrhage After Lateral Ventricle Drainage

Objective:To obtain meropenem pharmacokinetics/Pharmacodynamics parameters in plasma/cerebrospinal fluid（CSF）in patients with cerebral hemorrhage after lateral ventricle drainage.Methods:Patients（seven male and three female）who suffered from stroke-associated pneumonia after lateral ventricle drainage of cerebral hemorrhage,were admitted to the emergency internal medicine.They were treated with meropenem.1.0g of meropenem was fully dissolved in 100 ml of 0.9%saline as a 2h infusion,the concentrations of meropenem in plasma/CSF were determined by high-performance liquid chromatography.Pharmacokinetic software（WinNonlin 6.1）is used to calculate pharmacokinetic parameters and non-compartmental model was employed.The following parameters were calculated:peak time（Tmax）,peak concentration（Cmax）,elimination half-life(T_1/2),area under the curve(AUC_0-t),apparent volume of distribution（Vd）and total clearance（CL）.Using Crystal Ball software to perform Monte Carlo simulation（MCS）in order to calculate%T>MIC and the probability of target（PTA）attainment according to the PK/PD model.Results:The Cmax and AUC values in plasma was 17.79±3.38μg/ml,46.95±4.37h·μg/ml,respectively.The Cmax and AUC values in CSF was 6.51±1.11μg/ml,24.53±4.28 h·μg/m,respectively.The average penetration rate of meropenem in the CSF was 52.25%.When the MIC value was 1μg/ml,using 40%T>MIC,PTA was>90%in the blood and cerebrospinal fluid.Conclusions:Meropenem has a good penetration rate in the cerebrospinal fluid of this patient.When the pathogen MIC value is 1ug/ml,the patient is given meropenem1.0g q8h as a 2-hour infusion,good pathogen coverage can be achieved.Get a good therapeutic effect.