[Imipenem-cilastatin in infections]

Area of Science:

• Infectious Diseases
• Pharmacology
• Clinical Microbiology

Background:

• Severe infections, often hospital-acquired, pose significant therapeutic challenges.
• Gram-negative bacilli are common causative agents in serious infections.
• Evaluating novel antibiotic efficacy is crucial for combating antimicrobial resistance.

Purpose of the Study:

• To assess the therapeutic and ecological impact of imipenem-cilastatin in patients with infectious pathologies.
• To determine the clinical efficacy of imipenem-cilastatin across various infection types.

Main Methods:

• A multicentre open trial involving 200 patients with severe infections.
• Imipenem-cilastatin administered at 30 mg/kg/day for an average of 14.1 days.
• Analysis of clinical cure rates, bacterial eradication, and adverse events.

Main Results:

• High clinical cure rate of 90.9% (180/198) observed.
• Effective eradication of Pseudomonas strains, despite emergence of resistance in 4 cases.
• Excellent success rates in intra-abdominal infections (100%), septicaemia (94%), and urinary tract infections (97%).
• Lower respiratory tract infections showed an 82% success rate, a high figure for clinical trials.

Conclusions:

• Imipenem-cilastatin is a highly effective treatment for severe bacterial infections, including hospital-acquired ones.
• The drug demonstrates a favorable safety profile with low incidence of colonization or superinfection.
• Judicious use of imipenem-cilastatin is warranted for severe infections caused by susceptible pathogens.