Continuous regional arterial infusion therapy with biapenem and nafamostat mesilate for severe acute pancreatitis

• Published in: Suizo Vol. 23; no. 5; pp. 578 - 586
• Main Authors: HAMADA, Yukihiro, IMAIZUMI, Hiroshi, WATANABE, Masaaki, KIKUCHI, Hidehiko, NISHIMAKI, Hiroshi, KIDA, Mitsuhiro, SUNAKAWA, Keisuke, SOUMA, Kazui, SAIGENJI, Katsunori, MATSUBARA, Hajime, YAGO, Kazuo
• Format: Journal Article
• Language: Japanese
• Published: Japan Pancreas Society 2008
• Subjects: Biapenem; Continuous regional arterial infusion; Severe acute pancreatitis
• ISSN: 0913-0071; 1881-2805
• DOI: 10.2958/suizo.23.578

Recently, studies about continuous regional arterial infusion (CRAI) of a protease inhibitor and antibiotics therapy for SAP have been reported to evaluate the efficacy. Imipenem/cilastatin (IPM/CS) has a broad spectrum and has been frequently used as antibiotic for CRAI. However, the problem is decreased stability, which occurs by co-administration with nafamostat mesilate (NM). Meanwhile, biapenem (BIPM) is a more stable physicochemical compared with other carbapenem antibiotics. We experienced six cases of SAP using CRAI with BIPM and NM. The survival rate was 83.3%. One case was complicated by a pancreatic abscess and another case died of sepsis due to MRSA enterocolitis which was unrelated pancreatic infection. Based on these results, CRAI with BIPM for SAP is easier to manage than that with IPM/CS. IPM/CS as well as BIPM can yield favorable clinical results.