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[Treatment of moderate or severe infections using imipenem/cilastatin. 41 cases based on a multicenter protocol]
Abstract:
Imipenem and cilastatin in combination have a broad spectrum in vitro with a strong killing activity on most bacteria. Using a multicenter study design, we investigated 41 patients with moderate or severe infections: septicemia in 18 cases (Gram negative rods in 10, Gram positive cocci in 7 and combination of both in 1), pneumonia in 7, osteitis in 4, soft tissue infection in 7, infection of the genitourinary tract in 6 and miscellaneous infections in the remaining cases (1 abscess of the pancreas, 1 typhoid fever, 1 presumptive endocarditis). All of the bacteria were susceptible to imipenem/cilastatin: MICs ranged from 0.02 to 0.8 mg/l and MBCs from 0.015 to more than 10 mg/l. All patients except one recovered or improved under imipenem/cilastatin. The patient who failed to respond had septicemia due to a methicillin-resistant Staphylococcus aureus with a MBC and MIC above 10 and 0.5 mg/l respectively. Tolerance was outstanding: only 4 patients had adverse effects requiring withdrawal of the drug.
Insights
The combination of imipenem/cilastatin demonstrated broad-spectrum efficacy against various bacterial infections in a multicenter study. Most patients experienced recovery or improvement, with excellent drug tolerance.
Area of Science:
- Microbiology
- Pharmacology
- Infectious Diseases
Context:
- Imipenem/cilastatin is a broad-spectrum antibiotic combination with potent in vitro bactericidal activity.
- Moderate to severe bacterial infections pose significant clinical challenges.
- Assessing antibiotic efficacy and tolerance in diverse patient populations is crucial.
Purpose:
- To evaluate the clinical efficacy and tolerance of imipenem/cilastatin in patients with moderate to severe infections.
- To determine the susceptibility of causative pathogens to imipenem/cilastatin.
Summary:
- A multicenter study involved 41 patients with infections including septicemia, pneumonia, osteitis, and soft tissue infections.
- All bacterial isolates were susceptible to imipenem/cilastatin, with low minimum inhibitory concentrations (MICs).
- Ninety-seven percent of patients recovered or improved, with only four experiencing adverse effects requiring drug withdrawal.
Impact:
- Imipenem/cilastatin shows high clinical effectiveness and excellent tolerance in treating a wide range of bacterial infections.
- The study supports the use of imipenem/cilastatin as a reliable therapeutic option for severe bacterial infections.
- Understanding treatment outcomes, especially in cases involving resistant strains like methicillin-resistant Staphylococcus aureus, informs clinical decision-making.