From the Research
Providencia rettgeri is not universally susceptible to meropenem (Merrem), as some strains have developed carbapenem resistance through various mechanisms, including carbapenemase production, as reported in a 2021 study 1.
Key Points to Consider
- The emergence of resistance to multiple antimicrobial agents in pathogenic bacteria, including Providencia rettgeri, is a significant public health threat, as highlighted in a 2016 study 2.
- A 2021 study 1 found that a P. rettgeri strain was resistant to meropenem, with a minimum inhibitory concentration (MIC) of 64 μg/ml, indicating carbapenem resistance.
- Another study from 2020 3 reported the emergence of carbapenem-resistant P. rettgeri producing IMP-type metallo-β-lactamase in Japan, further emphasizing the concern of resistance.
- The usual adult dosage of meropenem for serious infections is 1 gram intravenously every 8 hours, though this should be adjusted for patients with renal impairment, but its effectiveness against P. rettgeri should be confirmed through susceptibility testing.
- Treatment duration typically ranges from 7-14 days depending on the infection site and severity, but the choice of antibiotic should be guided by culture and susceptibility results, especially considering the potential for carbapenem resistance in P. rettgeri, as noted in studies 1, 4, 3.
Clinical Implications
- Given the potential for carbapenem resistance, it is crucial to obtain a culture with susceptibility testing before initiating therapy with meropenem for P. rettgeri infections.
- The development of resistance in P. rettgeri underscores the need for stringent infection control practices and antibiotic stewardship to prevent the spread of resistant strains, as emphasized in a 2016 study 2.
- Clinicians should be aware of the local epidemiology of antibiotic resistance and adjust their treatment choices accordingly, considering the most recent and highest quality evidence available, such as the 2021 study 1 highlighting carbapenem resistance in P. rettgeri.