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Extended Infusion Meropenem — SCE Infectious Diseases MCQ

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HardAntimicrobial StewardshipExtended Infusion MeropenemSCE Infectious Diseases

A critically ill patient receives meropenem for a susceptible Gram-negative infection. Which statement about prolonged or continuous beta-lactam infusion and BLING III is accurate?

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Correct answer: B — It increased day-14 clinical cure while the reduction in unadjusted 90-day mortality was not statistically significant

Beta-lactams exhibit time-dependent activity, so prolonged infusion improves free-drug time above MIC. BLING III found higher clinical cure at day 14, but its primary unadjusted comparison of 90-day mortality was 24.9% versus 26.8%, odds ratio 0.91, p=0.08. It therefore did not prove the mortality benefit claimed in the original explanation.

Reference: BLING III: https://jamanetwork.com/journals/jama/fullarticle/2819971