Your browser doesn't support javascript.
loading
Effects of meropenem supply restriction: A multicenter retrospective study.
Koutake, Yoshimichi; Nagasaki, Yoji; Hirata, Ryosuke; Soejima, Keiji; Nishi, Hiromi; Tsukada, Hiroko; Hamasaki, Shohei; Hashimoto, Masashi.
Afiliação
  • Koutake Y; Department of Pharmacy, Clinical Research Institute, NHO Kyushu Medical Center, 1-8-1 Jigyouhama, Chuo-ku, Fukuoka 810-8563, Japan. Electronic address: kotake.yoshimichi.rv@mail.hosp.go.jp.
  • Nagasaki Y; Department of Infectious Diseases, NHO Kyushu Medical Center, Fukuoka, Japan.
  • Hirata R; Department of Pharmacy, Clinical Research Institute, NHO Kyushu Medical Center, 1-8-1 Jigyouhama, Chuo-ku, Fukuoka 810-8563, Japan.
  • Soejima K; Department of Pharmacy, NHO Nagasaki Medical Center, Nagasaki, Japan.
  • Nishi H; Department of Pharmacy, NHO Fukuoka Higashi Medical Center, Fukuoka, Japan.
  • Tsukada H; Department of Pharmacy, NHO Beppu Medical Center, Oita, Japan.
  • Hamasaki S; Department of Pharmacy, NHO Kagoshima Medical Center, Kagoshima, Japan.
  • Hashimoto M; Department of Pharmacy, Clinical Research Institute, NHO Kyushu Medical Center, 1-8-1 Jigyouhama, Chuo-ku, Fukuoka 810-8563, Japan.
J Infect Chemother ; 2024 Jul 18.
Article em En | MEDLINE | ID: mdl-39029622
ABSTRACT

BACKGROUND:

In Japan, the supply of one generic meropenem product was restricted from August 2022 to March 2023.

OBJECTIVE:

To determine the effects of meropenem (MEPM) restriction.

METHODS:

We conducted a multicenter retrospective study comparing antimicrobial use, bacteremia mortality, and drug-resistant bacteria detected before the restriction of MEPM (control period), from September 2021 to February 2022, and after the restriction of MEPM (MEPM supply restriction period), from September 2022 to February 2023, in five institutions.

RESULTS:

The number of carbapenem days of therapy (DOTs) were decreased in all five institutions. Fourth-generation cephalosporin DOTs increased in all facilities, and piperacillin/tazobactam DOTs increased in four facilities. The 30-day and 90-day mortality rates were significantly higher during the MEPM supply restriction period than those during the control period. Moreover, survival time was significantly shorter during the MEPM supply restriction period than that during the control period. Multivariable analysis revealed that MEPM supply restriction, age >80 years, Pitt Bacteremia Score ≥4, platelet count <10 × 104/µL, serum albumin level <2.5 g/dL, and methicillin-resistant Staphylococcus aureus bloodstream infection were independent risk factors for 30-day mortality. The detection rates of carbapenem-resistant Pseudomonas aeruginosa and Enterobacteriaceae did not differ significantly between the two periods.

CONCLUSIONS:

MEPM supply restriction decreased the use of carbapenems and increased the use of other broad-spectrum antimicrobial agents, which worsened the prognosis of bacteremia. Overall, carbapenems are important drugs for the treatment of infectious diseases and are difficult to replace in unforeseen situations such as drug supply outages.
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article