Immune response in patients with intra-abdominal infections treated with carbapenems.
The immune responses against isolated microorganisms in patients with intraabdominal infections treated with meropenem or imipenem/cilastatin were investigated. Fifty-nine patients received meropenem 500 mg t.i.d. intravenously for 3-21 days (mean 5.4 days) and 50 patients imipenem/cilastatin 500 mg/500 mg t.i.d. intravenously for 3-17 days (mean 5.1 days). Three serum samples were taken from each patient, the first sample at admission, the second sample between three and seven days after start of antibiotic treatment, and the third sample between 14 and 28 days later. Ninety-eight per cent of the patients in the meropenem group and 95% of the patients in the imipenem/cilastatin group were cured. There was no difference in the clinical outcome between the two treatment groups. Escherichia coli, Bacteroides fragilis group, anaerobic cocci, Staphylococcus epidermidis, and Klebsiella spp. predominated among the isolated microorganisms. Thirty-nine patients in the meropenem group had significant immune responses against one or more of the isolated microorganisms while 31 patients in the imipenem/group had significant responses. E. coli and B. fragilis gave rise in antibody titres in most patients indicating that these species are the most important pathogens in intraabdominal infections.
Brismar
B
B
Department of Surgery, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
Eklund
A E
AE
Nord
C E
CE
D018784:Abdominal Abscess / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000032:analysis*; D001420:Bacteria, Aerobic / Q000276:immunology / Q000302:isolation & purification; D001421:Bacteria, Anaerobic / Q000276:immunology / Q000302:isolation & purification; D015780:Carbapenems / Q000627:therapeutic use*; D015377:Cilastatin / Q000276:immunology / Q000627:therapeutic use; D005455:Fluorescent Antibody Technique; D006801:Humans; D015378:Imipenem / Q000276:immunology / Q000627:therapeutic use; D007275:Injections, Intravenous; D000077731:Meropenem; D008875:Middle Aged; D013845:Thienamycins / Q000276:immunology / Q000627:therapeutic use
D000907:Antibodies, Bacterial; D015780:Carbapenems; D013845:Thienamycins; D015377:Cilastatin; D015378:Imipenem; D000077731:Meropenem