Efficacy and safety of meropenem in the treatment of antimicrobial-resistant post-operative chest infections: a case series

Introduction
Meropenem is a β-lactam ultra-broad spectrum injectable antibiotic used to treat a wide variety of infections. Its effectiveness and safety in antimicrobial-resistant infections have been scarcely assessed in African patients. This study evaluated the outcomes and adverse effects associated with the use of meropenem for the treatment of antimicrobial-resistant post-operative chest infections.

Material and methods
The study was conducted at Memfys Hospital for Neurosurgery, a specialist hospital in Enugu, Nigeria. Between September and November 2017, a total of 32 patients (aged above 50 years) presented with an episode of chest infection 24–48 h after an operative procedure. Twenty-eight of these patients were prescribed ceftriaxone and other suppressive antibiotics as first-line treatment. Seven of these patients presented with antimicrobial resistance and were subsequently treated with meropenem and were considered to meet the criteria for the study. Sputum culture, white cell count and axillary temperature were obtained for diagnostic guidance in all patients.

Results
The mean age was 61 ±9 years, 6 were male, all patients were HIV and tuberculosis negative, 1 patient was diabetic, another had an ulcer and another was hypertensive. Regarding outcomes, all patients were completely treated for chest infection complications. However, a mild side effect was observed in 1 patient.

Conclusions
Meropenem is an effective and safe antibiotic as evidenced by bacterial culture and the mild adverse effect profile in post-operative patients with antimicrobial-resistant infections.