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Imipenem use in serious childhood infections
D Pavesio1, P Pecco, M Giacchino
1Admittance Dept. Regina Margherita Children's Hospital, Turin, Italy.
Abstract:
Imipenem plus cilastatin is a beta-lactam antibiotic with a broad spectrum and good tolerance. For this its use is indicated in serious infections even in children. The authors carried out a preliminary bacteriological study in patients affected by serious infection, cystic fibrosis, tumors, neutropenia, subjects undergoing intensive therapy and those with abdominal surgical infection. Isolated microorganism sensitivity in these patients, towards imipenem was very high (89%-100%). With these premises, 35 patients with serious infections in various locations were treated only with imipenem. Of these, 15 were oncologic neutropenic and 20 normal. In the first group therapeutic success was 66.6% and in the second one 80%. Local and systemic tolerance always showed good results.
Insights
Imipenem-cilastatin is a broad-spectrum antibiotic effective against serious infections in children and adults. Clinical studies show high sensitivity and good tolerance, with successful treatment outcomes in diverse patient groups.
Area of Science:
- Infectious Diseases
- Pharmacology
- Critical Care Medicine
Background:
- Imipenem-cilastatin is a beta-lactam antibiotic known for its broad spectrum and favorable safety profile.
- It is indicated for treating severe infections across various patient populations, including pediatric cases.
Purpose of the Study:
- To evaluate the bacteriological sensitivity of imipenem in patients with serious infections.
- To assess the therapeutic efficacy and tolerance of imipenem monotherapy in complex patient cohorts.
Main Methods:
- A preliminary bacteriological study was conducted on patients with severe infections, including those with cystic fibrosis, tumors, neutropenia, intensive care unit (ICU) stays, and abdominal surgical infections.
- Sensitivity testing of isolated microorganisms to imipenem was performed.
- A subsequent clinical trial treated 35 patients with serious infections (15 oncologic neutropenic, 20 non-neutropenic) using imipenem monotherapy.
Main Results:
- Microorganism sensitivity to imipenem ranged from 89% to 100% in the initial bacteriological study.
- Therapeutic success rates for imipenem monotherapy were 66.6% in oncologic neutropenic patients and 80% in non-neutropenic patients.
- Both local and systemic tolerance to imipenem were consistently good across all treated patients.
Conclusions:
- Imipenem demonstrates high in vitro sensitivity against a broad range of pathogens causing serious infections.
- Imipenem monotherapy is an effective and well-tolerated treatment option for serious infections, including in immunocompromised and neutropenic patients.
- The antibiotic's efficacy and safety profile support its use in complex clinical scenarios.