Pharmacokinetic/Pharmacodynamic Analysis Of Imipenem In Plasma And Peritoneal Liquid In Chinese Patients With Perforated Upper Gastrointestinal Tract

Perforated upper gastrointestinal tract is a common clinical critical illness, whether the commonly used dosing regimens of imipenem (1 g, every 12 h) are reasonable is still unclear. The aim of this study was to perform pharmacokinetic/pharmacodynamic (PK/PD) evaluation of imipenem in these patients. Eleven patients were enrolled, and the probability of target attainment (PTA) was calculated by the time that drug concentrations were above the minimum inhibitory concentration (%T > MIC) by Monte Carlo simulation. When 40%T > MIC was applied, the PTA in plasma and peritoneal liquid were > 90% with MIC <= 4 mu g/mL, even when MIC increased to 8 mu g/mL, it was still > 90% in plasma. But the PTA achieving 100%T > MIC only when breakpoint was decreased to 1 mu g/mL. In conclusion, this is the first study on the PK/PD of imipenem in both plasma and peritoneal draining liquid. However, further large and more abundance clinical trials are required.