Penetration of meropenem in plasma and abdominal tissues from patients undergoing intraabdominal surgery

We assessed the penetration of a new carbapenem antibiotic, meropenem, into abdominal tissues. A single 1,000-mg intravenous dose was administered to 66 patients undergoing elective intraabdominal surgery. Plasma, body fluid (peritoneal fluid and bile), and tissue samples (colon, gallbladder, omentum, stomach, fascia, muscle, and skin) were taken at various times up to 8 hours after administration of the dose. Meropenem concentrations were determined by means of validated bioassay techniques. Peak meropenem concentrations in most tissue specimens and one body fluid occurred within ~1 hour; the exceptions were bile and muscle specimens, in which peak concentrations were present in ~2 to ~4 hours. The bile concentration increased with time, thus indicating active excretion of drug into bile. Only one adverse event (mild nausea) was attributable to meropenem. Our results show that meropenem achieves adequate tissue concentrations for the treatment of intraabdominal infections due to susceptible bacteria.