Meropenem (1.5 g/day) is as effective as imipenem/cilastatin (2 g/day) for the treatment of moderately severe intra-abdominal infections.
This multicentre, open-label, randomised trial compared meropenem (0.5 g/8 h) and imipenem/cilastatin (at the commonly used dosage of 0.5 g/6 h) in monotherapy in patients with moderately severe intra-abdominal infections (IAIs). In total, 161 patients were randomised (82 meropenem, 79 imipenem/cilastatin). The mean APACHE II scores in the two groups were 5.8 and 6.4, respectively. At the end of therapy, 65/71 (91.6%) evaluable meropenem recipients were clinically cured or improved, compared to 60/64 (93.8%) imipenem/cilastatin recipients. This difference and that in an intention-to-treat analysis (82.1 vs 86.1%, respectively), were not statistically significant. Both drugs were generally well tolerated. Thus, meropenem 0.5 g/8 h is as clinically effective and well tolerated as imipenem/cilastatin 0.5 g/6 h in moderately severe IAIs.
Zanetti
G
G
Division of Infectious Diseases, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. giorgio.zanetti@chuv.hospvd.ch
Harbarth
S J
SJ
Trampuz
A
A
Ganeo
M
M
Mosimann
F
F
Chautemps
R
R
Morel
P
P
Lew
D
D
Zimmerli
W
W
Lange
J
J
Glauser
M
M
D018806:APACHE; D000328:Adult; D015377:Cilastatin / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D010538:Peritonitis / Q000188:drug therapy*; D013845:Thienamycins / Q000008:administration & dosage / Q000627:therapeutic use*
D013845:Thienamycins; D015377:Cilastatin; D015378:Imipenem; D000077731:Meropenem