[The clinical efficacy of imipenem/cilastatin sodium in orthopedic infections and drug levels in the bone tissue].
We evaluated the clinical efficacy of imipenem/cilastatin sodium (IPM/CS--a carbapenem antibiotic) against orthopedic infections, and the drug levels of the bone tissues were determined. The clinical efficacies for 6 patients in the infection group were good in 3 cases, and fair in the other 3; giving an efficacy rate of 50%. Bacteriologically, 8 strains were isolated from patients with the infection and an eradication rate of 87.5% was obtained upon the treatment. In 39 patients that were given the drug prophylactically, no postoperative infections occurred. Mean IPM levels in the bone and the bone marrow at 1 hour after administration in 5 patients of the prophylactic group were 17.3 micrograms/ml and 5.9 micrograms/g, respectively. The ratio of concentrations the bone to those in the bone marrow was 34.6%. The results of this study suggest that IMP/CS reaches to the bone tissue providing sufficient concentrations and that the drug is efficacious for the prophylaxis and the treatment of orthopedic infections.
Handa
N
N
Department of Orthopedic Surgery, Kochi Medical School.
Kawakami
T
T
Kitaoka
K
K
Ueda
E
E
Shinjou
H
H
Shimizu
T
T
Itou
K
K
Iwakawa
M
M
Yamamoto
H
H
Ando
M
M
Yamanaka
N
N
Nakauchi
M
M
Nieda
T
T
Kondou
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001842:Bone and Bones / Q000378:metabolism*; D015377:Cilastatin / Q000493:pharmacokinetics / Q000627:therapeutic use; D000077728:Cilastatin, Imipenem Drug Combination; D004338:Drug Combinations; D004359:Drug Therapy, Combination / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015378:Imipenem / Q000493:pharmacokinetics / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control
D004338:Drug Combinations; D015377:Cilastatin; D015378:Imipenem; D000077728:Cilastatin, Imipenem Drug Combination