Abstract

Background:
Antimicrobial resistance, particularly due to multidrug-resistant (MDR) gram-negative pathogens, poses a major therapeutic challenge in India. Despite several clinical studies on the effectiveness of meropenem in various infections, there is a dearth of studies among clinicians.

Aim:
To evaluate expert opinion on the clinical use of meropenem in the management of MDR infections in Indian clinical settings.

Methods:
This cross-sectional study employed a 23-item, multiple-choice questionnaire to gather expert opinions from clinicians with MDR management experience in Indian settings. The questionnaire covered current practices, clinical observations, and perceived efficacy of meropenem for managing MDR infections. Descriptive statistics summarize the data, with categorical variables shown as percentages.

Results:
This study included 412 respondents. Approximately 40% of clinicians reported that 21%–30% of patients with infections preferred meropenem. The majority of participants (72.82%) reported a preference for meropenem in meningitis, ventilator-associated pneumonia (VAP), and bloodstream infections. Nearly 81% of clinicians indicated that meropenem was the preferred drug of choice for treating gram-negative MDR pathogens. More than half of the participants (51.7%) reported that their preferred intravenous dose of meropenem was 1 g administered in two to three divided doses for treating MDR, extensively drug-resistant, or pandrug-resistant infections, while 46% preferred a dose of 2 g in two to three divided doses. Most participants (60.92%) indicated a preference for meropenem–sulbactam in complex infections such as complicated intra-abdominal infections, meningitis, and complicated urinary tract infections (cUTIs).

Conclusion:
This study highlights the widespread use of meropenem in the management of severe MDR infections, particularly meningitis, VAP, and bloodstream infections. Meropenem remains the preferred agent for gram-negative MDR pathogens, with most clinicians favoring standard intravenous dosing of 1–2 g in divided doses. Its frequent use in cUTIs and its preference for meropenem–sulbactam in complex infections further underscore its clinical importance.

Key words: Antimicrobial resistance; Infections; Meningitis; Meropenem; Multidrug-resistant.