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MIT-LCP / mimic-code

MIMIC Code Repository: Code shared by the research community for the MIMIC family of databases
https://mimic.mit.edu
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Meropenem infusion duration #1246

Closed FeifanXie closed 2 years ago

FeifanXie commented 2 years ago

Hi,

As previously pointed out (vanco administration #372), the documented infusion time in MIMIC III for antibiotics like vancomycin is always 1 minute duration (endtime - start time) , which is not the ground truth. It seems that the same issue applies for the MIMIC IV.

We recently work on the pharmacokinetics/pharmacodynamics of meropenem treatment in ICU patients from the MIMIC IV, and the actual infusion duration is important for the pharmacokinetic modeling. We were wondering if it is possible to get the actual infusion duration of meropenem in MIMIC IV?

Thanks in advanced!

alistairewj commented 2 years ago

You could try looking at the eMAR data for the subset of patients who have it. I haven't investigated the data in detail but it may have more duration information.

FeifanXie commented 2 years ago

Thank you for the suggestion. I have checked the eMAR data. Unfortunately, the infusion duration information is not recorded for meropenem.

alistairewj commented 2 years ago

Hrm, unfortunately don't have good suggestions at this time. I can give you the dosing guidelines at the hospital though:

Standard dosing recommendations of meropenem dosing are 1000mg Q8H for patients with adequate renal function (CrCl > 50mL/min). The BIDMC meropenem preferred dose and schedule for selected patients is 500mg Q6H based on pharmacodynamic models and clinical data.

Pharmacodynamic dosing Dose/schedule adjustment
Recommended dose for patients with CrCl > 50 mL/min 500 mg IV Q6H (including Pseudomonas aeruginosa)
CrCl 25-49 mL/min 500mg IV Q8H
CrCl 10-24 mL/min 500mg IV Q12H
CrCl < 10 mL/min 500 mg IV Q24H
HD 500mg Q24H administered post-HD
PD Not recommended
CRRT 500mg IV Q8H
Traditional dosing Dose/schedule adjustment
Recommended dose for patients with CrCl > 50 mL/min 1000 mg IV Q8H (for patients with special dosing recommendations excluded from the protocol)
CrCl 25-49 mL/min 1000mg IV Q12H
CrCl 10-24 mL/min 500mg IV Q12H
CrCl < 10 mL/min 500 mg IV Q24H
HD 500mg Q24H administered post-HD
PD Not recommended
CRRT 1g IV Q12H
FeifanXie commented 2 years ago

Thank you very much! The provided information makes sense for me.