Prolonged infusion of meropenem is more effective than intermittent infusion in reducing mortality, improving clinical outcomes, and enhancing microbial eradication, without increasing adverse events.

These benefits are particularly evident in patients with lower disease severity (APACHE II < 20), emphasizing the importance of patient stratification in optimizing treatment strategies. Fourteen studies were included, with a total of 1,698 patients. Prolonged infusion of meropenem was associated with a significantly lower mortality rate compared to intermittent infusion (RR = 0.81, 95% CI: 0.68–0.98). It also significantly improved clinical improvement rates (RR = 1.35, 95% CI: 1.11–1.64) and microbial eradication rates (RR = 1.19, 95% CI: 1.08–1.32). There were no statistically significant differences in ICU length of stay or hospital length of stay. Subgroup analyses showed that prolonged infusion was significantly associated with lower mortality and better clinical improvement rates in patients with an APACHE II score < 20.

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