Objective To analyze the influence of prolonging infusion time of meropenem on prognosis of elderly patients with sepsis.
Methods A total of 111 elderly patients with sepsis were randomly divided into control group (n=55) and observation group (n=56). Patients in both groups were conducted with intravenous infusion of 0.5 g meropenem, the control group completed infusion within 30 minutes, while the observation group completed infusion within 60 minutes. Clinical indexes, adverse reactions and incidence of multiple organ dysfunction syndrome (MODS) were compared between the two groups. According to the 21-day survival status in the hospital, the 111 patients were divided into survival group (n=88) and death group (n=23), and a binary Logistic regression model was used to analyze the factors affecting the prognosis of elderly patients with sepsis. Relationship between different infusion time of meropenem and prognosis of elderly patients with sepsis was analyzed.
Results The time of antibiotic use and hospital stay in the Intensive Care Unit (ICU) in the observation group were (8.31±2.01) and (9.14±1.89) days respectively, which were significantly shorter than (11.02±1.49) and (11.06±2.01) days in the control group (P < 0.05). The overall incidence of adverse reactions was 5.4% (3/56) in the observation group, which showed no significant difference when compared to 7.3% (4/55) in the control group (P=0.678). The incidence of MODS was 17.9% (10/56) in the observation group, which was significantly lower than 34.5% (19/55) in the control group (P < 0.05). Out of 111 cases, 88 patients survived within 21 days in hospital, and 23 died with a mortality rate of 20.7%. Compared to the survival group, the death group had higher ratios of patients with decreased platelet count, increased lactate level and 30 minutes infusion time of meropenem, and there were significant differences between two groups (P < 0.05). Logistic regression analysis showed that decreased platelet count, increased lactate level and infusion time of meropenem (30 minutes) were the influencing factors for the prognosis of elderly patients with sepsis (P < 0.05).
Conclusion Prolonging the infusion time of meropenem to 60 minutes can improve the rehabilitation efficiency of elderly patients with sepsis, and reduce the incidence of MODS and the risk of adverse prognosis.
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