Imipenem/cilastatin (1.5 g daily) versus Meropenem (3.0 g daily) in Patients with Intra-abdominal Infections: Results of a Prospective, Randomized, Multicentre Trial

• Published in: Scandinavian journal of infectious diseases 1997, Vol.29 (5), p.503-508
• Main Authors: Basoli, Antonio, Meli, Emanuele Zarba, Mazzocchi, Paolo, Speranza, Vincenzo, Group, Study
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Aged; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; APACHE; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Bacterial Infections - drug therapy; Biological and medical sciences; Cilastatin - administration & dosage; Cilastatin - therapeutic use; Female; Human bacterial diseases; Humans; Imipenem - administration & dosage; Imipenem - therapeutic use; Infectious diseases; Infusions, Intravenous; Male; Medical sciences; Middle Aged; Prospective Studies; Protease Inhibitors - administration & dosage; Protease Inhibitors - therapeutic use; Thienamycins - administration & dosage; Thienamycins - therapeutic use; Treatment Outcome
• ISSN: 0036-5548; 1651-1980
• DOI: 10.3109/00365549709011863

An open-label prospective, randomized, parallel multicentre study was undertaken to compare the efficacy and tolerability of 1.5 g/day intravenous imipenem/cilastatin with 3 g/day intravenous meropenem in the treatment of intra-abdominal infections. A total of 287 patients were enrolled; 201 patients, divided between the 2 treatment groups, were evaluable. Clinical outcome, bacteriological outcome, untoward microbiological effects, and clinical and laboratory adverse experiences were evaluated. 98% of patients receiving imipenem/cilastatin therapy were cured, with 96% showing eradication of infection. 95% of those on meropenem were cured, with 98% showing eradication. These differences in clinical and bacteriological outcome between the 2 treatments were not statistically significant. Two patients receiving imipenem/cilastatin and 5 receiving meropenem had untoward microbiological effects. There was a 0.7% frequency (1/139 patients) of possibly or probably drug-related clinical cr laboratory adverse experiences with imipenem/cilastatin and a 2.7% frequency (4/148) with meropenem. The mean time to defervescence was significantly less for patients in the imipenem/cilastatin treatment group than for those receiving meropenem. This study shows that 1.5 g/day of imipenem/cilastatin is equivalent to 3.0 g/day meropenem in clinical and bacteriological outcome, as well as in incidence of side effects.