Efficacy of prolonged administration time of meropenem in treatment of hematological malignancies patients complicated with infections after chemotherapy

Shao Qun; Fang Yu-yan; Ge Jian; Li Wen-jun; Lin Yun-fei; Liu Ling-xiao; Feng Lei; Hu Xiao-wu

doi:10.3969/j.issn.1672-8157.2025.01.031

Abstract：Objective To observe the clinical efficacy and safety of prolonged administration time of meropenem and routine intermittent administration in treatment of the hematological malignancies patients complicated with infections after chemothera-py.Methods By means of open-label randomized controlled single blind study,totally 80 hematological malignancies patients who were hospitalized in The First Affiliated Hospital of Anhui University of Science and Technology and were complicated with infection after chemotherapy were enrolled in the study and were divided into the experimental group and the control group,with 40 cases in each.The experimental group was treated with the prolonged infusion time of meropenem,while the control group was given the conventional intermittent administration of meropenem.The efficacy and safety were observed and compared between the two groups.The patients of the experimental group were divided into the agranulocytosis group with 19 cases and the non-agran-ulocytosis group with 21 cases according to the status of complication with agranulocytosis.The patients of the control group were divided into the agranulocytosis group with 16 cases and the non-agranulocytosis group with 24 cases according to the status of complication with agranulocytosis.The clinical efficacy was respectively observed and compared between the agranulocytosis group of the experimental group and the agranulocytosis group of the control group as well as between the non-agranulocytosis group of the experimental group and the non-agranulocytosis group of the control group.Results With regard to the efficacy,the clinical cure plus effective rate of the experimental group was 85.00%,higher than 55.00%of the control group,and there was significant difference(χ2=8.571,P<0.05).The bacterial eradication rate of the experimental group was 69.57%,higher than 52.63%of the con-trol group,and there was significant difference(χ2=1.265,P>0.05).The length of hospital stay of the experimental group was(12.20±4.97)days,shorter than(16.98±6.60)days of the control group.The hospitalization cost of the experimental group was(17 003.08±8 513.30)yuan,less than(24 343.18±12 471.68)yuan of the control group,and there were significant differences(t=-3.656,-3.074,P<0.05).The body temperature,inflammatory factors procalcitonin(PCT),CRP and serum amyloid protein A(SAA)of the experi-mental group were respectively(37.09±0.83)℃,(0.49±1.19)ng·mL-1,(27.65±22.83)mg·L-1 and(40.20±33.08)mg·L-1,lower than(37.55±0.61)℃,(2.47±4.03)ng·mL-1,(53.53±48.90)mg·L-1 and(74.91±67.17)mg·L-1 of the control group,and there were signifi-cant differences(t=-2.864,-2.975,-2.997,-2.864,P<0.05).The incidence of adverse reactions was 20.00%in the experimental group,25.00%in the control group,and there was significant difference(χ2=0.287,P>0.05).Among the patients with agranulocytosis,the efficacy of the prolonged administration time group was 78.95%,higher than 43.75%of the routine administration group.The length of hospital stay of the prolonged administration time group was(14.74±5.14)days,shorter than(21.19±6.67)days of the routine administration group.The hospitalization cost of the prolonged administration time group was(17 562.72±9 869.52)yuan,less than(28 624.06±16 100.95)yuan of the routine administration group.Among the patients with non-agranulocytosis,the effective rate of the prolonged administration time group was 90.48%,higher than 62.50%of the routine administration group.The length of hospital stay of the prolonged administration time group was(9.90±3.576)days,shorter than(14.17±4.92)days of the routine administration group.The hospitalization cost of the prolonged administration time group was(16 496.71±7 286.65)yuan,less than(21 489.25±8 569.08)yuan of the routine administration group,and there were significant differences(all P<0.05).Conclusion As compared with the routine intermittent administration,the prolonged administration time of meropenem can improve the clinical effect on treat-ment of the hematological malignancies patients complicated with infections after chemotherapy,shorten the length of hospital stay and reduce the hospitalization cost without increase of adverse reactions.