This study arises from the need to optimize antibacterial drug usage to face increasing drug
resistance among gram-negative pathogens in intensive care units. Gram-negative organisms are
responsible for 70% of drug-resistant infections acquired in the intensive care unit.
Meropenem is a β-lactam, carbapenem, antibacterial agent usually administered by intermittent
infusion. As β-lactam efficacy is determined by the time in which the drug concentration
exceeds the minimum inhibiting concentration of the target pathogen, intermittent infusion of
this short half-lived drug can lead to precipitous drops in serum drug levels, an occurrence
linked to emergence of resistant pathogens. The investigators hypothesize a beneficial effect
of a continuous meropenem infusion on mortality and emergence of drug resistant pathogens.
All patients enrolled will receive 1 g of meropenem bolus. After that, subjects will be
randomized to receive a continuous infusion of study drug 3g/day or a bolus administration of
the same amount of drugs. The investigators expect a reduction of mortality and emergence of
extensive or pan drug resistant pathogens from 52 to 40% in the continuous infusion group.