Condition 1: Ventilator-Associated Pneumonia. Condition 2: Augmented Renal Clearance. Ventilator associated pneumonia
Conditions
Interventions
Intervention 1: Intervention group: 9g Meropenem in a day as a 30-minute bolus, 9vials of ( Afapenem 1g) will be administered , every vial diluted in 5-20 ml of normal saline and administered as 3g
Sponsors
Ahvaz University of Medical Sciences
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Age over 18 years Patients with Augmented Renal Clearance (creatinine clearance greater than 130 mL/min/1.73 m2 body surface area) based on ( ARC score ,ARCTIC score) Individuals who have developed Ventilator-Associated Pneumonia (48 hours after intubation) according to CPIS criteria and require treatment with the Meropenem antibiotic. With chest radiography (one of: CT, MRI, CXR) that proves the presence of new or progressive bacterial infiltrates in the 48 hours prior to the study.
Exclusion criteria
Exclusion criteria: Decreased or no urination Being on Dialysis Pregnancy Allergy to Beta-Lactams Patients who have been treated with another Antibiotic more than 24 hours ago Serum Creatinine greater than 1.3 mg/dl
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Duration of treatment. Timepoint: Days 1,2,3,4,4,5,6,7. Method of measurement: The number of days the patient receives antibiotics.;Duration of mechanical ventilation. Timepoint: Days 1,2,3,4,4,5,6,7. Method of measurement: The number of days the patient is ventilator dependent.;Mortality. Timepoint: Days 1,2,3,4,4,5,6,7. Method of measurement: Death of patients.;SOFA score. Timepoint: Days 1,2,3,4,4,5,6,7. Method of measurement: The tool assesses vital organ dysfunction in patients in the Intensive Care Unit (ICU) and helps predict the risk of death. The tool assesses six vital organ systems, and the higher the score, the higher the risk of death.;ARC score. Timepoint: Day 1. Method of measurement: It is a clinical tool to predict the likelihood of increased renal clearance (ARC) in patients. It is calculated based on factors such as age under 50 years, trauma, SOFA score less than 4. A total score above 6 indicates a high probability of ARC.;Creatinine clearance. Timepoint: Days1,3,7. Method of measurement: Based on the patient's 8-hour urine collection from 12 midnight to 8 am.;Clinical Improvement. Timepoint: Days 1,2,3,4,4,5,6,7. Method of measurement: Complete or partial improvement of leukocytosis, fever, PaO2 / FiO2, clinical signs and symptoms within 48-72 hours after treatment of the infection, as confirmed by a specialist physician. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactPardis Aghaebrahimi Samani
Ahvaz University of Medical Sciences
Outcome results
None listed