Clinical trial of imipenem/cilastatin in severely burned and infected patients.
Imipenem/cilastatin was examined for safety and efficacy in a population of 20 seriously burned patients with acute bacterial infections. The study was made up of 18 males and two females with an average age of 38 years and average burn size of 52 per cent of the total body surface area. Inhalation injury was present in 14 patients. The infections treated included 16 pulmonary, two urinary tract, one wound and one bacteremia. Treatment was clinically successful in 13 patients; five patients had no improvement and the clinical response could not be determined in two in whom multisystem organ failure preceded the treated infection. All of the clinical failures were in the pulmonary infection group. No serious toxicity or side effects were noted. No patient died while receiving the drug or as a consequence of known failure of the drug. Microbiologic success was noted in 12. Resistant organisms developed in eight of whom five were in the clinical failure group. Pseudomonas aeruginosa resistant to imipenem/cilastatin was isolated from seven patients and occurred at an average of 3.6 days after treatment was begun.
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology; D002056:Burns / Q000150:complications*; D015377:Cilastatin; D002986:Clinical Trials as Topic; D003521:Cyclopropanes / Q000627:therapeutic use*; D004338:Drug Combinations; D004341:Drug Evaluation; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D015378:Imipenem; D008297:Male; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D013845:Thienamycins / Q000627:therapeutic use*
D003521:Cyclopropanes; D004338:Drug Combinations; D013845:Thienamycins; D015377:Cilastatin; D015378:Imipenem