title: Intramuscular imipenem as adjuvant therapy for acute cholecystitis and perforated or gangrenous appendicitis.
abstract: An open-label prospective study was performed employing intramuscularly administered imipenem as an adjunct to surgery in 20 patients with acute cholecystitis and 24 patients with perforated or gangrenous appendicitis. Three (12.5%) septic failures occurred in appendicitis patients and 2 (10%) failures in cholecystitis patients. There were no deaths. Adverse effects were minor, and there was no toxicity. Although failures were not associated with in vitro resistance, Pseudomonas spp. were recovered from 2 of 3 appendicitis failures. Intramuscular imipenem appeared to be an effective single-drug antimicrobial when used as an adjunct to surgery in patients with acute cholecystitis or perforated appendicitis. It should be a more cost-effective alternative to the current multiple-drug therapy frequently employed in patients with intra-abdominal sepsis.
authors.affiliation: Department of Surgery, Los Angeles County-University of Southern California Medical Center.
authors.forename: A E
authors.initials: AE
authors.lastname: Yellin
authors.forename: P N
authors.initials: PN
authors.lastname: Heseltine
authors.forename: T V
authors.initials: TV
authors.lastname: Berne
authors.forename: M D
authors.initials: MD
authors.lastname: Appleman
authors.forename: M A
authors.initials: MA
authors.lastname: Gill
authors.forename: F C
authors.initials: FC
authors.lastname: Chenella
mesh_terms: D000328:Adult; D001064:Appendicitis / Q000188:drug therapy* / Q000601:surgery; D002764:Cholecystitis / Q000188:drug therapy* / Q000601:surgery; D015377:Cilastatin / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D000077728:Cilastatin, Imipenem Drug Combination; D003131:Combined Modality Therapy; D004338:Drug Combinations; D005260:Female; D005734:Gangrene; D006207:Half-Life; D006801:Humans; D015378:Imipenem / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D007273:Injections, Intramuscular; D007416:Intestinal Perforation; D008012:Lidocaine; D008297:Male; D011446:Prospective Studies; D012422:Rupture, Spontaneous
chemical_list: D004338:Drug Combinations; D015377:Cilastatin; D015378:Imipenem; D000077728:Cilastatin, Imipenem Drug Combination; D008012:Lidocaine