Expert Opinion on the Prescription Practice of Carbapenem Antibiotics for the Treatment of Drug-Resistant Bacterial Infections in Indian Settings

Objective: The current survey-based study aims to gather expert opinions on the prescription practice of carbapenem antibiotics for the treatment of drug-resistant bacterial infections in Indian clinical settings.

Methods: The cross-sectional, multiple-response questionnaire-based survey involving professionals with expertise in treating pathogenic illnesses was carried out between 2022 and 2023. The questionnaire comprised 25 questions, the majority of which dealt with the use of antibiotics as monotherapy and in various combinations to treat pathogenic illnesses.

Results: Out of 302 survey participants, 83% of them preferred meropenem medications more frequently than imipenem, biapenem, doripenem, and other antibiotics to treat pathogenic infections. For the management of multidrug-resistant (MDR), extensively drug-resistant (XDR), or pan-drug-resistant (PDR) infections, approximately 54% of the respondents preferred the administration of 1 gm of IV meropenem in 2 to 3 divided doses. About 61% of the responders suggested using IV meropenem together with colistin to treat infections. The combination of IV meropenem with β-lactams, aminoglycosides, tigecycline, colistin, and others was preferred by 91% of the respondents for the treatment of MDR, XDR, and PDR infections. For treating difficult intra-abdominal infections, meningitis, and urinary tract infections (UTIs), almost 43% of the respondents preferred meropenem in combination with sulbactam.

Conclusion: The survey findings emphasize the prominent role of meropenem, either as a standalone treatment or in combination with other antibiotics in the management of challenging infections caused by MDR, XDR, or PDR pathogens. In specific scenarios involving difficult intra-abdominal infections, meningitis, and UTIs, clinicians recommended meropenem in combination with sulbactam antibiotics.