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Intramuscular imipenem/cilastatin for treatment of mild and moderately severe bacterial infections
C A Keller1, J Villavicencio, C Ramirez
1Department of Internal Medicine, Roosevelt Hospital, Guatemala City.
Abstract:
The efficacy and safety of intramuscularly administered imipenem/cilastatin was studied in 70 patients with mild or moderately severe bacterial infections (skin and soft tissue infections, respiratory tract infections, urinary tract infections and pelvic infections). Doses of imipenem/cilastatin ranged from 0.5 to 0.75 g twice daily. Fifty-five patients were evaluable for bacteriological efficacy; in the remaining 15 patients no pathogens were isolated or susceptibility data were lacking. MIC50 and MIC90 of imipenem were 0.12 mg/l and 0.5 mg/l, respectively, for Gram-negative pathogens isolated and 0.25 mg/l and 0.5 mg/l, respectively, for Gram-positive pathogens. Only one strain (a Flavobacterium odoratum) was resistant to imipenem. Clinical cure and bacteriological elimination was achieved in 94% of evaluable patients while 3% showed marked clinical improvement. Two patients were considered therapeutic failures. No clinical adverse effects were noted. Abnormal liver transaminases were recorded in 23% of the patients and 11% developed eosinophilia. In no patient was imipenem/cilastatin discontinued due to adverse effects. It is concluded that intramuscular imipenem/cilastatin in these patients was well tolerated and efficacious.
Insights
Intramuscular imipenem/cilastatin demonstrated high efficacy and safety in treating bacterial infections. This antibiotic combination achieved a 94% cure rate with minimal adverse effects in patients.
Area of Science:
- Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Bacterial infections pose a significant health challenge.
- Effective antibiotic therapy is crucial for patient outcomes.
- Imipenem/cilastatin is a broad-spectrum antibiotic combination.
Purpose of the Study:
- To evaluate the efficacy and safety of intramuscular imipenem/cilastatin.
- To assess treatment outcomes in patients with various bacterial infections.
- To determine the microbiological spectrum and resistance patterns.
Main Methods:
- A study involving 70 patients with mild to moderate bacterial infections.
- Administration of imipenem/cilastatin at 0.5 to 0.75 g twice daily.
- Evaluation of clinical and bacteriological efficacy in 55 evaluable patients.
Main Results:
- High efficacy with 94% clinical cure and bacteriological elimination.
- Low incidence of resistance, with only one resistant strain (Flavobacterium odoratum) identified.
- Adverse effects included transient abnormal liver transaminases (23%) and eosinophilia (11%), with no discontinuations.
Conclusions:
- Intramuscular imipenem/cilastatin is a well-tolerated and effective treatment option.
- The antibiotic demonstrated broad activity against common Gram-positive and Gram-negative pathogens.
- Further investigation into specific infection types may be warranted.