[An imipenem-cilastatin combination in the treatment of infection at general intensive care units].
The purpose of this multicentre open trial carried out in 286 patients (mean age: 58 +/- 17 years) was to evaluate the effectiveness of imipenem-cilastatin in the treatment of severe infections observed in intensive care units. In more than 90 per cent of the cases an underlying pathology was present before the infection, and 41 per cent of the patients had previously been operated upon. Respiratory tract infections and septicaemias accounted for 75 per cent of the cases. The infection had been present for 7.1 +/- 8.2 days before treatment was instituted, and in 66 per cent of the cases it was nosocomial. The frequency of prolonged artificial ventilation (198 cases) demonstrated the severity of these infections. Seventy-three per cent of the initial 622 isolates were Gram-negative bacilli; the responsible organisms were Pseudomonas aeruginosa in 106 cases and Acinetobacter in 76 cases. Imipenem-cilastatin was administered alone in 173 cases and combined with other antibiotics in 113 cases. The mean dosage and duration of treatment were 29.2 +/- 9.9 mg.kg-1 and 13.4 +/- 7 days respectively. Clinical cure or improvement was achieved in 244 out of 284 assessable patients (65.2 per cent). Among the 40 therapeutic failures, 16 were due to a resistant organism isolated during treatment (P. aeruginosa 10, P. maltophilia 6). These good or very good clinical results show that imipenem is effective in the treatment of severe infections observed in intensive care units.
Gouin
F
F
Département d'Anesthésie-Réanimation Marseille-Sud, Hôpital Sainte-Marguerite.
D000328:Adult; D000368:Aged; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D015377:Cilastatin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D015377:Cilastatin; D015378:Imipenem
L'association imipénème-cilastatine dans le traitement des infections en réanimation polyvalente.