Meropenem Continuous Infusion in a Septic Patient with Periprosthetic Infection and End-Stage Renal Disease Undergoing Prolonged Intermittent Renal Replacement Therapy

This case report highlights the use of continuous infusion of meropenem in a 42-year-old septic female patient with periprosthetic infection and end-stage renal disease receiving prolonged intermittent renal replacement therapy (PIRRT). Antibiotic infusion in patients receiving renal replacement therapy has its own peculiarities. There are many studies on the optimal dosing regimen for meropenem in renal dysfunction, but studies on the optimal infusion duration in these patients are limited. The patient was admitted with complaints of wounds, necrosis zones of the right upper limb, restriction of joint movements, and temperature increase up to 38 °C. The patient was treated with a continuous infusion of meropenem 2 g per day receiving renal replacement therapy three times a week (12 h). Also during hospitalization, the patient underwent hip disarticulation and excision of necrotic tissues. The patient was further transferred to a specialized nephrology department for further treatment. We believe that in this clinical case, the use of continuous infusion of meropenem in the complex therapy of sepsis in a patient with CKD undergoing PIRRT sessions helped to lead to clinical improvement in the patient. Further studies are needed.