TISSUE CONCENTRATIONS AND CLINICAL EFFICACY OF PANIPENEM/BETAMIPRON IN SURGICAL INFECTIONS

• Published in: CHEMOTHERAPY Vol. 39; no. Supplement3; pp. 585 - 595
• Main Author: Tanimura, Hiroshi
• Format: Journal Article
• Language: English; Japanese
• Published: Japanese Society of Chemotherapy 1991
• Subjects: Carbapenem; Panipenem/betamipron
• ISSN: 0009-3165; 1884-5894
• DOI: 10.11250/chemotherapy1953.39.Supplement3_585

In 14 cases of 30-60 min intravenous drip infusion of 0.5g/0.5g of panipenem/betamipron (PAPM/BP) and each 4 cases where 0.75g/0.75g and 1.0g/1.0g of the drugs were intravenously 60 min drip infused respectively, concentrations of panipenem (PAPM) in plasma, urine and individual tissues were measured. The results were as follows: 1) In 8 cases after an hour of an intravenous drip infusion of 0.5g/0.5g-1.0g/1.0g, not less than 0.2μg/g PAPM penetrated into the small and large intestinal walls with edema. Not less than 0.21μg/g of PAPM were also detected in the parietal peritoneum of the abdominal wall, the omentum, the musle of the abdominal wall, and the subcutaneous tissues. MIC80 of PAPM against 42 clinical isolates obtained from surgical infectious region in which PAPM/BP was used, were not less than 0.2μg/ml. The clinical effect was substantiated according to the tissue levels and MIC80. 2) In 3 postoperative cases of pancreatoduodenectomy, concentration of PAPM/BP was compared with that of imipenem/cilastatin (IPM/CS) by the crossover method. The results showed that concentrations of PAPM in bile were 7.40 and 8.0812μ/ml at peak in a dose of 0.5g/0.5g and 17.88μg/ml in a dose of 1.0g/1.0g. Peak levels of PAPM were 1.87, 3.42μg/ml in a dose of 0.5μ/0.5g, and 4.91μg/ml in a dose of 1.0μ/1.0g when passed into pancretic juice. These levels were almost the same levels as in the IPM/CS. To 15 cases of perforating peritonitis, 2 cases of liver abscess, 4 cases of cholecystitis and cholangitis, 3 cases of wound infection, 3 cases of periproctal abscess, and 1 cases of gallstone, namely, total 28 cases, 0.5g/0.5g of PAPM/BP 2 or 3 times a day or 1.0g/1.0g of the dose twice a day were given for 3-15 days. In 26 cases which could be evaluated, the effective rate was 84.6 %. Bacteriologically, 38 strains were eradicated in 39 isolates. Mild increases of GOT and GPT in 2 cases, and increase of LDH in 1 case were found. Accordingly, it may be said that PAPM/BP is a highly effective drug in the treatment of surgical infections.