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[Thienam (imipenem/cilastatin) as an agent for empirical antibiotic therapy]
Abstract:
The clinicobacteriological efficacy and tolerance of thienam (imipenem/cylastatin) were studied in the empirical therapy of 38 patients with severe purulent inflammatory diseases of various localization i.e. pneumonia, lung abscesses, pyothorax, peritonitis, abdominal abscesses, meningitis and brain abscesses. The treatment of all the patients with the drug was started before the data on the bacteriological investigation were available. Although the infections and the general state of the patients were extremely severe, the therapy with thienam proved to be efficient in 31 out of 35 cases (88.6 per cent) subjected to the drug efficacy estimation. The bacteriological diagnoses with respect to 24 out of 38 patients (64.7 per cent) were available later: 93.6 per cent of the isolates was sensitive to imipenem. The antimicrobial activity of imipenem against 254 clinical isolates assayed by the method of serial dilutions exceeded that of the majority of the currently used antimicrobial drugs, including aminoglycosides, 3rd generation cephalosporins and ureldopenicillins. The tolerance of thienam was good. Only in 4 out of 38 patients it was necessary to use some other drugs because of the side effects. Therefore, the use of the thienam is advisable as a drug of empirical monotherapy in patients with severe infections of the respiratory organs, abdominal cavity and central nervous system.
Insights
Thienam (imipenem/cilastatin) demonstrated high efficacy in treating severe infections like pneumonia and meningitis. This broad-spectrum antibiotic showed good tolerance, making it a recommended empirical monotherapy option.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Microbiology
Background:
- Severe purulent inflammatory diseases pose significant therapeutic challenges.
- Empirical antibiotic therapy is crucial when pathogen identification is pending.
Purpose of the Study:
- To evaluate the clinicobacteriological efficacy and tolerance of Thienam (imipenem/cilastatin).
- To assess Thienam as empirical monotherapy for severe infections.
Main Methods:
- Prospective study of 38 patients with severe infections.
- Administration of Thienam as empirical therapy before bacteriological data.
- In vitro susceptibility testing of clinical isolates to imipenem.
Main Results:
- Thienam showed 88.6% efficacy in 35 evaluable patients with severe infections.
- 93.6% of bacterial isolates were susceptible to imipenem.
- Thienam exhibited good tolerance, with side effects in only 4 patients.
Conclusions:
- Thienam is an effective and well-tolerated option for empirical monotherapy in severe respiratory, abdominal, and CNS infections.
- Its broad antimicrobial spectrum supports its use against a wide range of pathogens.
- Clinical efficacy and susceptibility data support Thienam's role in managing severe bacterial infections.