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Imipenem/cilastatin as secondary therapy for bacterial infections
1Department of Internal Medicine, Fukuoka University School of Medicine, Japan.
Abstract:
Imipenem/cilastatin (IPM/CS) was used to treat 39 documented infections in patients who had failed to respond to other antibiotic regimens. The overall response rating was 76.9%. Respiratory infections responded less frequently (efficacy rating, 55.6%) to IPM/CS than abdominal infections, urinary tract infections, or sepsis. Methicillin-resistant Staphylococcus aureus, Xanthomonas maltophilia, and Acinetobacter calcoaceticus were less sensitive to IPM/CS therapy than the other bacterial strains encountered. Respiratory tract infections were though to be less responsive to IPM/CS, probably because imipenem-resistant strains of S aureus were present in most of those cases. It is concluded that IPM/CS is well tolerated and effective in the treatment of various bacterial infections.
Insights
Imipenem/cilastatin (IPM/CS) effectively treated bacterial infections in patients unresponsive to other antibiotics, showing a 76.9% overall response rate. However, respiratory infections showed lower efficacy, potentially due to resistant bacteria.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Microbiology
Background:
- Imipenem/cilastatin (IPM/CS) is a broad-spectrum antibiotic combination.
- Previous treatments had failed in 39 patients with documented bacterial infections.
- Assessing IPM/CS efficacy in challenging cases is crucial.
Purpose of the Study:
- To evaluate the effectiveness of imipenem/cilastatin in patients with documented bacterial infections who did not respond to other antibiotic regimens.
- To identify specific infection types and bacterial strains with varying responses to IPM/CS therapy.
Main Methods:
- Retrospective analysis of 39 patients treated with imipenem/cilastatin.
- Infections included respiratory, abdominal, urinary tract, and sepsis.
- Bacterial susceptibility testing was performed for common pathogens.
Main Results:
- Overall treatment success rate was 76.9%.
- Respiratory infections had a lower efficacy rate (55.6%) compared to abdominal infections, urinary tract infections, and sepsis.
- Methicillin-resistant Staphylococcus aureus, Xanthomonas maltophilia, and Acinetobacter calcoaceticus exhibited lower sensitivity to IPM/CS.
Conclusions:
- Imipenem/cilastatin (IPM/CS) is a well-tolerated and effective treatment option for various bacterial infections.
- Lower response rates in respiratory infections may be linked to the presence of imipenem-resistant Staphylococcus aureus strains.
- Further investigation into resistance patterns is warranted for optimizing antimicrobial therapy.