Carbapenem-Resistant Enterobacteriaceae Treatment

Treatment Options

• For bloodstream infections with Carbapenem-Resistant Enterobacteriaceae (CRE), the Infectious Diseases Society of America recommends meropenem 1 gram IV every 8 hours by extended infusion (3 hours) in combination therapy 1, 2, 3
• For complicated intra-abdominal infections with CRE, meropenem 1 gram IV every 8 hours by extended infusion may be used in combination with other agents 1, 2, 3
• Extended-infusion of meropenem for 3 hours is suggested if meropenem MIC is ≥8 mg/L 3, 4
• The American Society of Health-System Pharmacists recommends meropenem/vaborbactam 4 grams IV every 8 hours for CRE infections when susceptible 5, 6

Infection Management

• For complicated intra-abdominal infections, the Surgical Infection Society recommends meropenem 1 gram every 8 hours IV as an effective single-drug regimen 7, 8
• Treatment duration should typically be 5-7 days, individualized based on infection site, source control, and clinical response 1, 2, 3
• The Society of Critical Care Medicine suggests that prolonged or continuous infusions should be considered for critically ill patients with healthcare-associated infections to optimize pharmacodynamic targets 8