BASIC AND CLINICAL STUDIES ON MEROPENEM IN THE SURGICAL FIELD

• Published in: CHEMOTHERAPY Vol. 40; no. Supplement1; pp. 520 - 536
• Main Authors: Yura, Jiro, Shinagawa, Nagao, Ishikawa, Shu, Mashita, Keiji, Suzui, Katsuya, Ishihara, Hiroshi
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Chemotherapy 1992
• Subjects: Meropenem
• ISSN: 0009-3165; 1884-5894
• DOI: 10.11250/chemotherapy1953.40.Supplement1_520

1) Antibacterial activity: The MIC50/MIC90 (μg/ml) values of meropenem against Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were 0.78/25, ≤0.05/≤0.05, ≤0.05/≤0.05 and 0.39/6.25, respectively. Meropenem was not as active as imipenem against S. aureus but was two to four-fold as active against three other bacteria. 2) Distribution in body fluid and tissue: The peak concentrations of meropenem in various body fluids and tissues after intravenous drip of 500 mg were 2.76-66.00μg/ml in bile in the bile duct, 1.38-32.60μg/ml in bile in the gallbladder, 3.05μg/g in muscle, 3.65 lg/g in the gallbladder wall, 1.80μg in subcutaneous fat and 4.50μg/ml in ascites. In the investigation of distribution to pus in postoperative intraperitoneal abscess, the peak concentration was 0.8μg/ml. 3) Clinical efficacy: Clinical efficacy was excellent in 9 cases, good in 32, fair in 8 and poor in 6, the efficacy rate being 74.5%. Regarding the bacteriological response of 97 clinical isolates, 71 strains were eradicated, while 18 persisted, and the outcomes in 8 were unknown. Thus, the eradication rate was 79.8%. As an adverse effect, renal failure occurred in cases accompanied by stomach cancer at the terminal stage and chronic renal disturbance. Eruption, found in 2 cases, dissapeared rapidly after discontinuation. Abnormal laboratory values were found in 14 cases, but except for those in the case of renal failure, all the episodes improved after completion of treatment.