Table 3

Characteristics of the studies, PK and dose recommendations related to meropenem

StudynPNAWeightTypeGroupModelModalityAdministered doseVdCLt1/2 (hours)Recommended dose
Wang et al,23 China9*2.00 (0.71–3.88) years11.50 (9.50–36.30)PChildren2-compartment with first-order
elimination with NONMEM
VV–VA20–40 mg/kg every 8 hours11.59 (5.92–20.19) vs 13.51 (3.71–20.80) L/hour
↓14.2% (compared with controls)
11.59 (5.92–20.19) vs 7.9±5.9 L/hour
↑46.7% (compared with adults)
The authors recommended the optimised dosing regimens for children with sepsis receiving ECMO depending on the PTA of PK target 50% t>MIC and 100% t>MIC, for children with sepsis during ECMO with different body weight, estimated Cl and MIC of bacteria.
Zylbersztajn et al,19 Chile948 (2–165) months16 (3.5–45)PChildren2-compartment with PmetricsVV–VA20–40 mg/kg every 8–12 hours0.289±0.295 L/kg
0.139±0.102 L/hour/kg
Across each dosing interval, 91% of patients achieved the PK/PD targets for adequate exposure for meropenem. Higher dosing with extended infusion was needed in the meropenem administration.
  • Boldfaced fonts represent comparisons with controls within the same study. In other studies, they represent comparisons with non-ECMO neonates from a different published study.

  • *Number of patients undergoing only ECMO circuit.

  • CI, continuous infusion; CL, clearance; ECMO, extracorporeal membrane oxygenation; MIC, minimum inhibitor concentration; NONMEM, non-linear mixed-effects modelling; P, prospective; PD, pharmacodynamics; PK, pharmacokinetics; PNA, postnatal age; PTA, probability of target attainment; t1/2, elimination half-life; VA, veno-arterial; Vd, volume of distribution; VV, veno-venous.