In vitro antimicrobial activity of meropenem and its therapeutic efficacy in respiratory infections

Yoshihiro Honda, Satoshi Shoji, Yutaka Tokue, Akira Watanabe, Masakichi Motomiya, Kiyoshi Konno, Teruo Hasuike, Tsuneo Sayama, Tohru Kanaya, Tukio Nagao, Satoshi Shindo, Jun ichi Saito, Yushi Nakai, Hideo Arai, Yoshiyuki Anzai

    Research output: Contribution to journalArticlepeer-review

    2 Citations (Scopus)

    Abstract

    The in vitro antimicrobial activity and lung tissue levels of meropenem (MEPM), a new carbapenem agent for parenteral use, was measured and its therapeutic efficacy in respiratory infection was evaluated. The minimum inhibitory concentrations (MICs) of MEPM, imipenem (IPM), ceftazidime (CAZ), cefotaxime and cefuzonam against methicillin-senstitive Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA), Haemophilus influenzae, Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens and Pseudomonas aeruginosa were determined by a micro-broth dilution method using the Dynatech MIC 2000 system. As shown by MICs, MEPM was the most active among the five antibiotics against E. coli, K. pneumoniae and E. cloacae, and was as active as CAZ against H. influenzae. In contrast, MEPM was less active than IPM against MSSA and MRSA. Penetration of MEPM into the lung tissue was studied in five patients who had undergone chest surgery. The lung tissue levels of MEPM 30 minutes after intravenous administration of 0.5 g ranged from 0.45 to 3.85 µg/g. A daily dose of 0.5–2.0 g of MEPM was given intravenously for 3–14 days to 44 patients: 30 with acute pneumonia, 4 with pulmonary abscess, 5 with bronchiectasis, 3 with infection supervening on lung cancer and 2 with pyelonephritis. Clinical effects were excellent in 4, good in 33, and poor in 4 cases. Three cases with infection supervening on lung cancer were excluded from clinical evaluation. Eosinophilia was observed in 4 patients and exanthema in 1. These adverse reactions disappeared after completion of the therapy. From the above results, we conclude that MEPM is one of the most useful carbapenem agents for parenteral use as a first choice treatment for respiratory tract infections.

    Original languageEnglish
    Pages (from-to)302-311
    Number of pages10
    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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