Fig. 3
Relationship between meropenem serum concentration and creatinine clearance. Meropenem serum concentrations 4 h (C4h) (a1, a2) and 8 h (C8h) (b1, b2, c) after start of infusion in non-CRRT (a1, b1, c) and CRRT (a2, b2) patients vs. median individual CLCRCG (patient level; a, b) or vs. all single CLCRCG (sample level; c) of the patients. Tick mark of x-axis (a, b) represents median individual CLCRCG at time of determined C4h or C8h value. Bold tick mark labels (a, b) represent ECMO patients. Grey tick mark labels (a1, b1) represent patient example mentioned in “Impact of renal function on meropenem exposure and target attainment” section of main text. Coloured symbols (a-c) represent renal function class of a patient at time of determined C4h or C8h value. Shaped symbols (a, b) represent study day on which C4h or C8h value was determined. Dashed vertical lines/horizontal arrows (a-c) represent separation of renal function classes. Dashed horizontal lines (a-c) represent EUCAST MIC breakpoints for Enterobacteriaceae, Pseudomonas spp. or Acinetobacter spp. (S/I 2 mg/L, I/R 8 mg/L [36]). Data points labelled with 36 (c) represent four C8h values of patient 36. Black curve (c) represents quantified hyperbolic relationship between CLCRCG and C8h values, excluding data of patient 36. Abbreviations: CLCR CG Creatinine clearance estimated according to Cockcroft and Gault [34]; CRRT Continuous renal replacement therapy; C 4h Meropenem serum concentration at 4 h after infusion start; C 8h Meropenem serum concentration at 8 h after infusion start; ECMO Extracorporeal membrane oxygenation; EUCAST European Committee on Antimicrobial Susceptibility Testing; ID Patient identifier; I/R Intermediate/resistant; MIC Minimum inhibitory concentration; S/I Susceptible/intermediate