Imipenem/Cilastatin Plasma Concentrations and Survival (Efficacy of Therapy) of Critically Ill Patients in Clinical Practice

The clinical efficacy and safety of using carbapenems in critically ill patients in a hospital setting under polypharmacotherapy were analyzed. Literature data gained from the PubMed system on the use of imipenem in critically ill inpatients were used in the analysis. The criterion for selecting publications was the availability of 14-day and 28-day mortality rates in critically ill patients in whom therapeutic concentrations of imipenem/cilastatin were achieved/not achieved. The absolute efficacy of achieving target plasma concentrations of imipenem and the effect on the survival of critically ill patients was 81.10% at 14 d and 73.6% at 28 d. The survival rates were 66.7% and 60.0%, respectively, when the target imipenem concentrations were not achieved. Currently, it seems necessary to introduce a therapeutic drug monitoring procedure for controlled achievement of target therapeutic concentrations of antibiotics together with a determination of their minimum inhibitory concentrations, first and foremost, in critically ill patients undergoing polypharmacotherapy.