Comparison of the clinical effectiveness of the two different doses of Meropenem in critically ill patients with hospital acquired or ventilator associated pneumonia: a randomized single-blind clinical trial

Comparison of the clinical effectiveness of two different regimens of the extended infusion of Meropenem in critically ill patients with hospital-acquired or ventilator-associated pneumonia

In this research, which designed a parallel single-blind randomized clinical trial, 62 eligible patients randomize in two subgroups of APACHE II ≥20, APACHE II <20, to receive one of the interventions. A code is allocated to each participants.

This study is conducted in the intensive care unit of Imam Khomeini educational hospital in Sari between 2018-19. The person who does the meropenem MIC test is blind to the interventions.

Critically ill patients who are admitted to the intensive care unit and suffered from hospital-acquired or ventilator-associated pneumonia had an indication to receive meropenem because probable infection with multi-drug resistance gram-negative bacteria enrolled in the study. Patients with renal dysfunction and in risk of developing seizure are excluded from the study.

The interventions arm receive the infusion of Meropenem 3 g TDS, and the control arm receive the infusion of Meropenem 2 g TDS.

Clinical success ( Time Frame: 7 days ) defined as the following, all measured at 7 days: - Patient alive - Complete or relative depletion of pneumonia sign and symptoms (leukocytosis, fever, sputum, dyspnea and tachypnea) - Systolic blood pressure >90 mmHg without need for vasopressor support - Stable or improved SOFA score, define as: .for baseline SOFA ≥ 3: a decrease of at least 30%; .for baseline SOFA <3: stable or decreased SOFA score -PaO2/FiO2 ratio stable or improved

Block randomization with sealed envelops

،he investigator who does the meropenem MIC test on bacteria which had been cultured from patients' sputum samples is blind to which patients receive which interventions.