Related Experiment Videos
[Chemotherapy with imipenem/cilastatin for severe infections accompanied by malignant hematological disorders]
Y Fujii1, Y Inoue, Y Hiroshige
1Third Department of Internal Medicine, School of Medicine, Yamaguchi University.
Abstract:
The clinical and bacteriological efficacy of imipenem/cilastatin (IPM/CS) was evaluated in 30 cases of serious infections associated with hematological malignancies. 1. Among 28 evaluable cases, excellent efficacy was obtained in 6 cases and good effectiveness in 10 cases, resulting in a high clinical efficacy rate (57.1%). The clinical effectiveness of IPM/CS was not dependent on neutrophil count in peripheral blood. A 53.8% efficacy rate was observed in 26 cases which had received pretreatment with other antibiotics. 2. Antibacterial activities of IPM/CS have so far been evaluated against organisms isolated in 20 of 28 cases: 2 strains of coagulase-negative Staphylococcus, 2 strains of methicillin-resistant Staphylococcus aureus, 2 strains of Enterococcus faecalis, 9 strains of Enterobacter cloacae, and 8 other strains. 3. Among 3 evaluable cases treated with IPM/CS alone, response was good in 1 case. Among 25 patients receiving IPM/CS in combination with an aminoglycoside or a penicillin, the efficacy rate was 60%. 4. Five patients had IPM/CS-related adverse events; nausea and vomiting in 2 cases, seizures in 1 case, small increases in GOT and GPT in 2 cases, and the appearance of casts in urine sediment in 1 case. These patients, however, tolerated the complete course of therapy with IPM/CS except the 2 cases with nausea and vomiting. These results indicate that chemotherapy with IPM/CS is effective for the treatment of severe infectious diseases accompanied by hematological disorders.
Insights
Imipenem/cilastatin (IPM/CS) shows significant clinical efficacy in treating serious infections in hematological malignancy patients. This broad-spectrum antibiotic is effective against various bacteria, with manageable side effects.
Area of Science:
- Infectious Diseases
- Hematology
- Pharmacology
Background:
- Patients with hematological malignancies are susceptible to serious infections.
- Effective antimicrobial therapy is crucial for managing these infections.
Purpose of the Study:
- To evaluate the clinical and bacteriological efficacy of imipenem/cilastatin (IPM/CS) in patients with hematological malignancies.
- To assess the safety and tolerability of IPM/CS in this patient population.
Main Methods:
- A study involving 30 patients with serious infections and hematological malignancies.
- Clinical efficacy assessed based on patient response.
- Bacteriological efficacy evaluated against isolated pathogens.
- Adverse events were monitored.
Main Results:
- A clinical efficacy rate of 57.1% was observed in 28 evaluable cases.
- IPM/CS demonstrated activity against Gram-positive and Gram-negative bacteria, including MRSA and Enterobacter cloacae.
- The combination therapy with aminoglycoside or penicillin showed a 60% efficacy rate.
- Adverse events were generally mild and manageable.
Conclusions:
- Imipenem/cilastatin (IPM/CS) is an effective treatment option for severe infections in patients with hematological disorders.
- The drug is well-tolerated, with most adverse events being transient.
- Further research may explore optimal combination therapies.