Dose-finding study on meropenem in bacterial pneumonia

Kohei Hara, Shigeru Kono, Hironobu Koga, Kazuo Ishida, Takashige Miyazaki, Akira Sakamoto, Toshiaki Hayashi, Masahiko Yoshimoto, Akira Saito, Ichiro Nakayama, Kazuo Takebe, Takeshi Osonoi, Yasuhisa Kuroda, Masakichi Motomiya, Akira Watanabe, Yoshihiro Honda, Otohiko Kunii, Hajime Nishiya, Jingoro Shimada, Kouya ShibaMasaki Yoshida, Osamu Sakai, Kihachiro Shimizu, Kyouichi Totsuka, Hiroshi Kino, Hiroyuki Kobayashi, Masahiko Yoshida, Shin Kawai, Hiroaki Takeda, Fumio Matsumoto, Iwao Sakurai, Takeo Imai, Tadashi Tamura, Takayuki Takahashi, Masayuki Morita, Shigeki Odagiri, Kaneo Suzuki, Kou Murohashi, Masaaki Arakawa, Koichi Wada, Takashi Kawashima, Norio Suzuki, Nobuki Aoki, Toshihiko Takeuchi, Yoshimitsu Hayashi, Kazuhide Yamamoto, Toshiyuki Yamamoto, Kanzo Suzuki, Satoru Adachi, Fumio Miki, Nobuhiro Narita, Masayoshi Sawaki, Keiichi Mikasa, Takao Sasaki, Yukio Matsumoto, Yuji Sugimoto, Rinzo Soejima, Masaru Sumi, Toshiharu Matsushima, Masayoshi Kawanishi, Michio Yamakido, Kenji Hasegawa, Keizo Matsumoto, Hirofumi Tanaka, Masaru Nasu, Jun Goto, Atsushi Saito, Hiroshi Fukuhara, Yuei Irabu, Keizo Kikkawa, Yoshiteru Shigeno, Hiroshi Nakamura, Mitsuyoshi Nakashima, Keizo Yamaguchi, Kazuyuki Sugawara

    Research output: Contribution to journalArticlepeer-review

    9 Citations (Scopus)

    Abstract

    To determine the optimal clinical dose of meropenem (MEPM), a new carbapenem antibiotic for injection, in bacterial pneumonia, a dose-finding study was conducted by the blind method using imipenem/cilastatin (IPM/CS) as the control drug. Patients were given 0.5 g of MEPM a day (L-group) or 1.0 g of MEPM a day (H-group), or 1.0 g/1.0 g of IPM/CS a day (IM-group) for 14 days as a rule. Almost all patients had bacterial pneumonia, but some had pulmonary suppuration, or mycoplasmal pneumonia or primary atypical pneumonia. The results as evaluated by the committee were as follows; 1. In the case of bacterial pneumonia, the clinical efficacy rate was 95.7% (22/23) in the L-group, 79.3% (23/29) in the H-group and 84.0% (21/25) in the IM-group. There was a significant difference between the L-group and the H-group. In the total population, the clinical efficacy rate was 89.3% (25/28) in the L-group, 80.6% (25/31) in the H-group and 79.3% (23/29) in the IM-group. There were no significant differences among the 3 groups. 2. Bacteriologically, the eradication rate was 70% (7/10) in the L-group, 100% (13/13) in the H-group and 75% (6/8) in the IM-group. There were no significant differences among the 3 groups. 3. Side effects were observed in 1 of 35 patients in the H-group and 1 of 32 patients in the IM-group. None were severe, however. 4. The incidence of abnormal changes in laboratory findings was 32.1% (9/28) in the L-group, 32.4% (11/34) in the H-group and 46.4% (13/28) in the IM-group. There were no significant differences among the 3 groups. All the changes were mild in degree. 5. The usefulness rate was 89.3% (25/28) in the L-group, 77.4% (24/31) in the H-group and 73.3% (22/30) in the IM-group. There were no significant differences among the 3 groups. From the above results we concluded that a daily dose of 0.5 g was the optimal clinical dose for MEPM in bacterial pneumonia.

    Original languageEnglish
    Pages (from-to)447-463
    Number of pages17
    JournalChemotherapy
    Volume40
    DOIs
    Publication statusPublished - 1992 Apr

    Keywords

    • Meropenem

    ASJC Scopus subject areas

    • Pharmacology (medical)
    • Infectious Diseases
    • Pharmacology
    • Drug Discovery
    • Oncology

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