title: [The clinical efficacy of imipenem/cilastatin sodium in orthopedic infections and drug levels in the bone tissue].
abstract: 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.
authors.affiliation: Department of Orthopedic Surgery, Kochi Medical School.
authors.forename: N
authors.initials: N
authors.lastname: Handa
authors.forename: T
authors.initials: T
authors.lastname: Kawakami
authors.forename: K
authors.initials: K
authors.lastname: Kitaoka
authors.forename: E
authors.initials: E
authors.lastname: Ueda
authors.forename: H
authors.initials: H
authors.lastname: Shinjou
authors.forename: T
authors.initials: T
authors.lastname: Shimizu
authors.forename: K
authors.initials: K
authors.lastname: Itou
authors.forename: M
authors.initials: M
authors.lastname: Iwakawa
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
authors.forename: M
authors.initials: M
authors.lastname: Ando
authors.forename: N
authors.initials: N
authors.lastname: Yamanaka
authors.forename: M
authors.initials: M
authors.lastname: Nakauchi
authors.forename: T
authors.initials: T
authors.lastname: Nieda
authors.forename: M
authors.initials: M
authors.lastname: Kondou
mesh_terms: 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
chemical_list: D004338:Drug Combinations; D015377:Cilastatin; D015378:Imipenem; D000077728:Cilastatin, Imipenem Drug Combination