Meropenem為半合成的廣效型抗生素，與早期使用的imipenem同屬於carbapenem類之微生物製劑。Meropenem在臨床上的使用範圍廣泛，對於經第三代cephalosporin治療後，產生抗藥性或混合細菌感染的問題（如ESBLs），可做有效的處置。依目前許多文獻顯示，ICU中發生呼吸器相關肺炎（ventilator-associatedpneumonia）、重度敗血症（severesepsis）、術後腹膜炎（post-operativeperitonitis），皆可以meropenem作為第一線的經驗性療法；同時對於免疫功能不全患者，臨床上發生疑似細菌感染（如neutropenicfever），病情不穩定時，可採經驗性的單獨使用，或合併它種抗生素使用。
Meropenem自三年前引進本院後，使用上有逐漸攀升之趨勢。而越來越多報告顯示，在廣泛的使用下，隨之而來可能產生的抗藥性。基於用藥之適切性、安全性與有效性，我們擬定meropenem藥物使用評估作業，於民國91年4月至91年11月，一方面收集使用meropenem的住院病患作評估，另一方面亦進行相同的回溯性研究，針對適應症、劑量、治療結果等加以分析。同時，比較兩組間的差異性來分析藥師於藥事照顧上的成效。
在兩組研究中，其適應症使用的適當性並無差異。但於處方劑量的合理性評估上，在有藥師介入的情形下，其不合理的比例有明顯下降的趨勢（p<0.05）。同時，藉由本次研究，除了瞭解meropenem院內使用情況外，使用規範的建立，亦可作為院內醫療人員日後用藥之準則，減少不合理的處方出現，節省醫療成本與保障病人用藥安全。

Meropenem, like imipenem, is a semi-synthetic carbapenem antibacterial agent that has a broad spectrum of activity against most common intensive care unit (ICU) pathogens. It is reported that meropenem is active against most clinically important gram-positive and gram-negative organisms including extended spectrum beta-lactamase (ESBL) producers that are capable of hydrolyzing the 3rd generation cephalosporin. Treatment with meropenem as the first-line empirical therapy was effective in severe sepsis, post-operative peritonitis and late onset ventilator-associated pneumonia. In patients with febrile neutropenia, early empirical use of meropenem or combined with other antibiotics is recommended.
The frequency of prescribing meropenem has been increasing since it was introduced to Chiayi Christian Hospital three years ago. It is known that frequently prescribed for minor infections result in the development of bacterial resistance, hence jeopardizing effectiveness when needed for future serious nosocomial infections. Based on the appropriateness, safety and efficacy of drug use, a retrospective drug utilization evaluation from April to July and a following concurrent drug utilization evaluation from August to November were performed for patients who received meropenem in 2002. To assess the effectiveness of interventions made by pharmacists, the indication, dosing regimens, microbiological data and clinical outcomes of these two groups were measured.
The results revealed that there was no difference between these two groups about the indication of therapy. However, the rate of inappropriate dosage of the group with intervention (12.1%) showed significant improvement, compared with 25.7% of the retrospective group (p < 0.05). In this study, besides the understanding the use of meropenem in our hospital, the drug utilization guideline established can provide a practice standard ensuring the safety of medicines, and also help to reduce drug expenditure.