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[Clinical evaluation of imipenem/cilastatin sodium in children]
Insights
Imipenem/cilastatin sodium (MK-0787/MK-0791) is a safe and effective antibiotic for treating various pediatric bacterial infections, showing high clinical and bacteriological cure rates. Further research is needed for resistant strains.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology and Therapeutics
- Antimicrobial Agents
Context:
- Bacterial infections in children require effective and safe treatment options.
- Imipenem/cilastatin sodium is a broad-spectrum antibiotic with established efficacy in adults.
- Pediatric pharmacokinetic and safety data for imipenem/cilastatin sodium were limited.
Purpose:
- To evaluate the safety, efficacy, and pharmacokinetics of imipenem/cilastatin sodium (MK-0787/MK-0791) in pediatric patients.
- To determine the clinical and bacteriological response rates in children with diverse bacterial infections.
- To assess the serum half-life of imipenem/cilastatin sodium in children.
Summary:
- Thirty pediatric cases of bacterial infections were treated with imipenem/cilastatin sodium (40-222 mg/kg/day for 2.25-13 days).
- Achieved a 93% clinical cure rate and 88% bacteriological efficacy rate across infections like tonsillitis, pneumonia, sepsis, and abscesses.
- Observed a serum half-life of 0.892 hours in children with normal renal function; one case of convulsions was possibly treatment-associated.
Impact:
- Imipenem/cilastatin sodium demonstrates significant safety and efficacy in pediatric bacterial infections.
- Identified potential treatment failures in specific resistant organisms like MRSA and non-typeable H. influenzae.
- Provides valuable pharmacokinetic data for optimizing imipenem/cilastatin sodium dosing in pediatric populations.
Abstract:
Imipenem/cilastatin sodium (MK-0787/MK-0791) was evaluated for its safety, efficacy and pharmacokinetics in children. Thirty cases of bacterial infections were treated with MK-0787/MK-0791 at a daily dose of 40 to 222 mg/kg for 2.25 to 13 days. Clinical cure rate was 93% and bacteriological efficacy rate was 88%. Treated diseases included severe tonsillitis due to mixed anaerobic infections, pneumonia, sepsis, brain abscess and soft tissue infections. Two cases, one with periosteomyelitis due to methicillin-resistant S. aureus and the other with pulmonary abscess due to Haemophilus influenzae (other than type b), failed to respond to the MK-0787/MK-0791 therapy. The serum half-life of MK-0787 was 0.892 hour in children with normal renal functions. An episode of convulsions in a case of sepsis with bacterial croup and brain edema was considered to be associated with the MK-0787/MK-0791 therapy. From the present study, MK-0787/MK-0791 appears a safe and effective antibiotic when used in children with a variety of bacterial infections.