Friday April 3, 2009 (pediatric pearl)

Q: Does sustained meropenem use have effect on the pattern of Gram-negative bacillus colonization in patients admitted to a tertiary care PICU?


Answer: No

In a prospective study, after a 6-mo baseline period, all children with serious infections admitted to the PICU during the subsequent 2 yrs were administered meropenem
.
During the period of preferred meropenem use, the amount of meropenem used increased me than orseven-fold, whereas the use of other advanced generation beta-lactams was reduced by nearly 80%.

Conclusion:

1. There was no statistically detectable effect on the prevalence of colonization by Gram-negative organisms resistant to one or more classes of broad-spectrum parenteral antibiotics

2. or to colonization by organisms resistant specifically to meropenem, when meropenem was the preferred antibiotic in a PICU.

3. The incidence of nosocomial infections did not change, and the prevalence of nosocomial infections caused by meropenem-resistant organisms was always less than 1% of all admissions during the period of meropenem preference.


Reference: click to get abstract

Meropenem use and colonization by antibiotic-resistant Gram-negative bacilli in a pediatric intensive care unit - Pediatric Critical Care Medicine:Volume 10(1)January 2009pp 49-54