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[Use of meropenem in patients with neutropenia]
G A Kliasova1, V G Savchenko, E N Parovichnikova
1Hematologic Research Centre, Russian Academy of Medical Sciences, Moscow.
Abstract:
Meropenem was used in the treatment of 14 infectious complications in 11 patients including 8 with acute myeloid leukemia due to the cytostatic therapy, 1 with chronic myeloid leukemia, 1 with aplastic anemia and 1 with acute intermittent porphyria. At the moment of the meropenem use critical neutropenia (less than 500 granulocytes per 1 ml) in 11 cases (79 per cent) was stated. The drug was administered as intravenous infusions in a dose of 1 g every 8 hours for 4 to 41 days (the median of 11 days). 9 out of the 14 infectious complications were cured (the body temperature normalized and all the inflammation foci were eliminated), among them 6 out of 8 pyocyanic sepsis. Eradication of gram-negative bacteria was observed in 8 out of 10 cultures of the biological materials. No toxic complications or electrolytic disorders due to the drug use were recorded. The drug tolerance was good.
Insights
Meropenem effectively treated infectious complications in patients with hematologic disorders, including acute myeloid leukemia. This broad-spectrum antibiotic demonstrated good tolerance and efficacy in critical neutropenic patients.
Area of Science:
- Infectious Diseases
- Hematology
- Pharmacology
Background:
- Patients with hematologic malignancies, such as acute myeloid leukemia, often experience severe infections due to cytostatic therapy.
- Critical neutropenia (<500 granulocytes/mL) is a common and serious complication in these patients, increasing infection risk.
- Gram-negative bacterial infections, including pyocyanic sepsis, pose a significant threat in immunocompromised individuals.
Purpose of the Study:
- To evaluate the efficacy and safety of meropenem in treating infectious complications in patients with hematologic disorders.
- To assess meropenem's effectiveness in critically neutropenic patients undergoing cancer therapy.
- To determine the eradication rate of gram-negative bacteria and overall clinical outcomes.
Main Methods:
- Meropenem was administered intravenously at 1g every 8 hours for 4 to 41 days (median 11 days).
- The study included 11 patients with 14 infectious complications, primarily those with acute myeloid leukemia undergoing cytostatic therapy.
- Infection resolution, bacterial eradication, and adverse events were monitored.
Main Results:
- Meropenem successfully treated 9 out of 14 infectious complications (64%), including 6 out of 8 cases of pyocyanic sepsis.
- Eradication of gram-negative bacteria was achieved in 8 out of 10 cultures.
- The drug was well-tolerated, with no recorded toxic complications or electrolyte disturbances.
Conclusions:
- Meropenem is an effective and safe treatment option for severe infections in neutropenic patients with hematologic disorders.
- The broad-spectrum activity of meropenem is crucial for managing gram-negative infections in this vulnerable population.
- Clinical improvement and bacterial eradication support the use of meropenem in managing infectious complications during cytostatic therapy.
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