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Prospective, randomised, multicentre study of meropenem versus imipenem/cilastatin as empiric monotherapy in severe nosocomial infections

  • J. Garau
  • J. Blanquer
  • L. Cobo
  • S. Corcia
  • M. Daguerre
  • F. J. de Latorre
  • C. León
  • F. Del Nogal
  • A. Net
  • J. Rello
Article

Abstract

The clinical and bacteriological efficacy and the tolerability of meropenem versus imipenem/cilastatin (both 1 g t.i.d.) in severe nosocomial infections were compared in a multicentre, randomised, nonblinded study. A total of 151 patients were recruited; 133 (66 meropenem, 67 imipenem/cilastatin) were clinically evaluable and 84 (42 meropenem, 42 imipenem/cilastatin) bacteriologically evaluable. Most clinically evaluable patients (90%) were in intensive care units, required mechanical ventilation (72%), and had received previous antibiotic therapy (62%). The mean (±SD) APACHE II score was 15.2 (±6.6) in the meropenem group and 17.8 (±6.8) in the imipenem/cilastatin group. The primary infections were nosocomial lower respiratory tract infections (56% of patients), intra-abdominal infections (15%), septicaemia (21%), skin/skin structure infections (5%), and complicated urinary tract infections (3%); 35% of the patients had two or more infections. There was no significant difference between the meropenem and imipenem/cilastatin groups in the rates of satisfactory clinical (weighted percentage 87% vs. 74%) or bacteriological (weighted percentage 79% vs. 71%) response. There was a slightly higher rate of clinical success with meropenem against primary or secondary lower respiratory tract infection (89% vs. 76%). Drug-related adverse events occurred in 17% and 15% of meropenem and imipenem/cilastatin patients, respectively. Meropenem (1 g t.i.d.) was as efficacious as the same dose of imipenem/cilastatin in this setting, and both drugs were well tolerated.

Keywords

Intensive Care Unit Mechanical Ventilation Urinary Tract Infection Weighted Percentage Evaluable Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© MMV Medizin Verlag GmbH 1997

Authors and Affiliations

  • J. Garau
    • 1
  • J. Blanquer
    • 2
  • L. Cobo
    • 3
  • S. Corcia
    • 4
  • M. Daguerre
    • 5
  • F. J. de Latorre
    • 6
  • C. León
    • 7
  • F. Del Nogal
    • 8
  • A. Net
    • 9
  • J. Rello
    • 10
  1. 1.Department of MedicineHospital Mútua de TerrassaBarcelonaSpain
  2. 2.Intensive Care ServiceHospital ClínicoValenciaSpain
  3. 3.Intensive Care ServiceHospital de CrucesBarakaldoSpain
  4. 4.Intensive Care ServiceHospital ClinicoSevilleSpain
  5. 5.Intensive Care ServiceHospital Príncipie de AsturiasMadridSpain
  6. 6.Intensive Care ServiceHospital Vall d'HebrónBarcelonaSpain
  7. 7.Intensive Care ServiceHospital de ValmeSevilleSpain
  8. 8.Intensive Care ServiceHospital Severo OchoaLeganés, MadridSpain
  9. 9.Intensive Care ServiceHospital de la Sta Creu i Sant PauBarcelonaSpain
  10. 10.Intensive Care ServiceConsorci Hospitalari del Parc TaulíSabadell, BarcelonaSpain

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