Efficacy of prolonged versus standard infusion meropenem in critically Ill pediatric patients with sepsis: A randomized controlled trial
DOI:
https://doi.org/10.61529/idjp.v35i3.450Abstract
Background: This study compared meropenem administered for a longer duration with its standard duration in suspected and confirmed bacterial sepsis. This study aims assess the efficacy of prolonged infusion meropenem versus standard infusion in critically ill patients admitted to the pediatric ICU.
Material and Methods: This randomized controlled trial included 150 critically ill pediatric patients and was conducted in the Pediatric Intensive Care Unit of PNS Shifa Hospital, Karachi, from 01 January 2025 to 30 June 2025. The trial was registered at ClinicalTrials.gov (NCT07122596). Children (1 month to 16 years) with suspected or proven bacterial sepsis who required meropenem intravenously were selected. Independent samples t-test or Mann–Whitney U test was used to compare continuous variables, and chi-square or Fisher's exact test was used to compare categorical variables. The relative risks with 95% confidence intervals were used to express the effects of treatment.
Results: Baseline characteristics were comparable between groups. The mean age was 7.7 ± 2.04 years in the prolonged infusion group and 7.6 ± 1.98 years in the standard infusion group. Day-7 clinical success was significantly higher with prolonged infusion (92.0% vs. 73.3%; RR 1.25, 95% CI 1.08–1.46; p=0.003), with greater microbiological eradication among culture-positive patients (91.4% vs. 75.4%; p=0.012). Prolonged infusion also reduced time to clinical improvement and PICU stay, while in-hospital mortality was lower but not statistically significant.
Conclusion: Prolonged infusion of meropenem improved clinical success and shortened PICU stay.
Keywords: Anti-bacterial agents, Critical illness, Infusions, Intravenous, Intensive care units, Meropenem, Pediatrics, Sepsis.
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Copyright (c) 2026 Dr. Nadia Iqbal, Dr. Khurram Fayyaz, Dr. Sadia Karim, Dr. Khadija yasmin, Dr. Nadeem Sadiq, Dr. Hajra Begum
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