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Meropenem versus imipenem/cilastatin in the treatment of intra-abdominal infections
B Brismar1, A S Malmborg, G Tunevall
1Huddinge Hospital, Sweden.
Abstract:
In order to compare the clinical and microbiological efficacy and safety of meropenem with imipenem/cilastatin, 249 patients with intra-abdominal infections participated in an open randomised comparative multicentre trial. Seventy-five men and 57 women (mean age 51 years) were enrolled in the meropenem group and 67 men and 50 women (mean age 52 years) in the imipenem/cilastatin group. The patients received either meropenem, 500 mg q 8 h, or imipenem/cilastatin, 500 mg/500 mg q 8 h by intravenous infusion for up to 17 days (mean 5 days). Ninety-seven of 99 patients (98%) receiving meropenem were clinically cured while 86 of 90 patients (96%) in the imipenem/cilastatin group were clinically cured. The microbiological response was satisfactory in 89 of 94 evaluable patients (95%) receiving meropenem and in 78 of 81 evaluable patients (96%) receiving imipenem/cilastatin. There was no significant difference in clinical and microbiological efficacy between the two treatment groups. Adverse reactions were noted in 26 patients receiving meropenem and in 36 patients receiving imipenem/cilastatin. The present study shows that meropenem is effective and well tolerated in the treatment of intra-abdominal infections.
Insights
Meropenem and imipenem/cilastatin show similar clinical and microbiological efficacy for intra-abdominal infections. Both antibiotics are effective and well-tolerated, with comparable safety profiles in this comparative study.
Area of Science:
- Infectious Diseases
- Clinical Pharmacology
- Microbiology
Background:
- Intra-abdominal infections (IAIs) are a significant cause of morbidity and mortality.
- Carbapenem antibiotics are crucial for treating severe bacterial infections, including IAIs.
- Meropenem and imipenem/cilastatin are commonly used broad-spectrum carbapenems.
Purpose of the Study:
- To compare the clinical and microbiological efficacy and safety of meropenem versus imipenem/cilastatin in patients with IAIs.
- To evaluate treatment outcomes and adverse events associated with each antibiotic regimen.
Main Methods:
- An open, randomized, comparative, multicenter trial involving 249 patients with IAIs.
- Patients received either meropenem (500 mg q 8 h) or imipenem/cilastatin (500 mg/500 mg q 8 h) intravenously for a mean of 5 days.
- Clinical cure rates, microbiological response, and adverse reactions were assessed.
Main Results:
- Clinical cure rates were high for both groups: 98% for meropenem (97/99) and 96% for imipenem/cilastatin (86/90).
- Microbiological response was satisfactory in 95% (89/94) of meropenem recipients and 96% (78/81) of imipenem/cilastatin recipients.
- Adverse reactions were reported in 26% of meropenem patients and 36% of imipenem/cilastatin patients, with no significant difference in overall efficacy.
Conclusions:
- Meropenem demonstrated comparable clinical and microbiological efficacy to imipenem/cilastatin in treating intra-abdominal infections.
- Both meropenem and imipenem/cilastatin were found to be effective and well-tolerated treatment options for IAIs.
- The study supports the use of meropenem as a viable alternative to imipenem/cilastatin for these infections.