Expert perspectives on the clinical use of meropenem monotherapy in the management of various antibiotic-resistant pathogens in Indian settings
DOI:
https://doi.org/10.18203/issn.2454-2156.IntJSciRep20250056Keywords:
Meropenem, Antibiotic resistance, Meningitis, Complicated urinary tract infections, Multidrug-resistant pathogensAbstract
Background: To gather expert perspectives on the clinical use of meropenem monotherapy in managing multidrug-resistant (MDR), extensively drug-resistant (XDR), and pan-drug-resistant (PDR) pathogens in Indian settings.
Methods: This cross-sectional study used a 20-item questionnaire to gather clinician opinions on prescription practices, clinical observations, and preferences regarding meropenem monotherapy. Descriptive statistics were employed to analyze the responses, presenting frequencies as percentages.
Results: A total of 353 clinicians participated in this study, with 37% reporting a 6-10% prevalence of MDR, XDR, and PDR pathogens in their practice. Complicated intra-abdominal infections (cIAIs) were the most common conditions treated with meropenem, reported by 54.96% of respondents. The majority (91.5%) of the respondents preferred combination therapy for resistant infections, with tigecycline (54%) and colistin (33.43%) being common choices. Key pathogens included Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, and Staphylococcus aureus. Most participants (58%) favored administering 1g of IV meropenem in 2 to 3 divided doses. Bloodstream infections, meningitis, and ventilator-associated pneumonia (VAP) were noted as primary indications for meropenem use. Additionally, 68% of participants stated meropenem was the most prescribed antibiotic for complicated urinary tract infections (cUTIs), while 77% indicated it as the preferred treatment for Gram-negative MDR pathogens.
Conclusion: Meropenem remains a critical option for treating MDR, XDR, and PDR infections in India, particularly in combination with tigecycline or colistin. Clinicians preferred its use in cIAIs and VAP, especially in elderly patients. The findings highlight the importance of continuously monitoring resistance patterns to optimize treatment strategies.
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