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[Antibacterial activity of panipenem against clinical isolates in 2000 and 2001]
Abstract:
As the post-marketing surveillance of panipenem/betamipron (Carbenin), MICs of panipenem (PAPM) against 1355 clinical isolates of 28 species from 15 medical institutions all over Japan from June 2000 to March 2001 were measured using the broth microdilution method approved by the Japanese Society of Chemotherapy and compared with those of parenteral carbapenem antibacterials, imipenem (IPM) and meropenem (MEPM), and parenteral cephem antibacterials, cefozopran, cefepime, and sulbactam/cefoperazone. The activity of PAPM was comparable to that of IPM against almost all species tested. Compared with MEPM, PAPM was more active against Gram-positive bacteria and Bacteroides spp., and less active against Gram-negative bacteria. Compared with the parenteral cephems, PAPM was more active against most of species tested and its MIC ranges were narrower than those of the cephems as were those of other carbapenems. In this surveillance study, the incidence of resistance in various species were as follows: 39.3% for methicillin-resistant Staphylococcus aureus, 47.3% for penicillin-intermediate Streptococcus pneumoniae (PISP), 15.1% for penicillin-resistant S. pneumoniae (PRSP), 0.9% for extended-spectrum beta-lactamase (ESBL) producing Escherichia coli, 3.4% for ESBL producing Klebsiella pneumoniae, 19.2% for beta-lactamase producing Haemophilus influenzae, 24.0% for beta-lactamase-negative ampicillin-resistant (BLNAR) H. influenzae, and 1.0% for metallo-beta-lactamase producing Pseudomonas aeruginosa. Against these resistant strains, carbapenems including PAPM showed generally more potent activity than cephems. It was noted that PAPM showed the most potent activity against PISP and PRSP, which showed high incidence of 62.4% totally, among tested drugs. Metallo-beta-lactamase producing P. aeruginosa exhibited high resistance and BLNAR H. influenzae also exhibited low susceptibility against all tested drugs. But no remarkable change in the activity of PAPM against other species was observed in this study compared with that in the studies before the marketing of Carbenin. Furthermore, it is necessary to pay much attention to the trend of resistant strains such as PRSP, metallo-beta-lactamase producing bacteria, and BLNAR H. influenzae.
Insights
Panipenem/betamipron (Carbenin) demonstrates potent activity against Gram-positive bacteria and comparable efficacy to imipenem. This carbapenem shows greater effectiveness than cephems against most tested species, including resistant strains.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Post-marketing surveillance of antibiotics is crucial for monitoring efficacy and resistance patterns.
- Carbapenems are broad-spectrum beta-lactam antibiotics critical for treating serious infections.
- Panipenem/betamipron (Carbenin) is a parenteral carbapenem antibiotic used in Japan.
Purpose of the Study:
- To evaluate the in vitro activity of panipenem (PAPM) against clinical isolates in Japan.
- To compare PAPM's efficacy with other carbapenems (imipenem, meropenem) and cephems.
- To assess resistance trends in various bacterial species, including methicillin-resistant Staphylococcus aureus and drug-resistant Streptococcus pneumoniae.
Main Methods:
- Broth microdilution method approved by the Japanese Society of Chemotherapy.
- Testing of 1355 clinical isolates from 28 species across 15 Japanese medical institutions (June 2000-March 2001).
- Comparison of Minimum Inhibitory Concentrations (MICs) with imipenem, meropenem, cefozopran, cefepime, and sulbactam/cefoperazone.
Main Results:
- PAPM activity was comparable to imipenem against most tested species.
- PAPM exhibited greater activity than meropenem against Gram-positive bacteria and Bacteroides spp.
- PAPM demonstrated superior activity and narrower MIC ranges compared to parenteral cephems, particularly against resistant strains like penicillin-intermediate and penicillin-resistant Streptococcus pneumoniae.
Conclusions:
- Panipenem/betamipron maintains potent activity against a wide range of clinical isolates, including key resistant pathogens.
- PAPM shows favorable activity profiles compared to other carbapenems and cephems, highlighting its role in combating bacterial resistance.
- Continued surveillance is essential to monitor emerging resistance trends, particularly for metallo-beta-lactamase producing Pseudomonas aeruginosa and beta-lactamase-negative ampicillin-resistant Haemophilus influenzae.