The relationship between the daily dosage of the carbapenem meropenem (MEPM) and MEPM-resistant Pseudomonas aeruginosa.
Pseudomonas aeruginosa is a pathogen which is known to be responsible for nosocomial infection. The appropriate use of antibiotics has become important for preventing the spread of drug-resistant P. aeruginosa. In Hara-doi Hospital, two carbapenem antibiotics, imipenem (IPM) and meropenem (MEPM), are used for patients aged 65 years or older at a daily dosage of 1.0 g and 0.5 g, respectively. Of P. aeruginosa samples isolated in 2003, the sensitivity to IPM was 54% and to MEPM it was 58%. In 2004, the sensitivity to IPM was 55%, i.e., not significantly different from 2003. In 2004, the daily dosage of MEPM was increased to 1.0 g/day, and the sensitivity to MEPM increased to 71%. Based on the Pharmacokinetics/Pharmacodynamics (PK/PD) theory, even though the patients were elderly, a sufficient dosage of antibiotics given over a shorter period of time was effective against MEPM-resistant P. aeruginosa in a hospital ward, and there were no side effects.
Harashima
Shin-ichi
S
Department of Clinical Research, Hara-doi Hospital, Fukuoka, Japan. harasima@metab.kuhp.kyoto-u.ac.jp
Kondo
Hiroko
H
Nabeshima
Atsuko
A
Shimoda
Masako
M
Yamaji
Kouzaburo
K
Horiuchi
Takahiko
T
Shimono
Nobuyuki
N
Ikematsu
Hideyuki
H
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D004305:Dose-Response Relationship, Drug; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D005260:Female; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage* / Q000493:pharmacokinetics; D008297:Male; D000077731:Meropenem; D008826:Microbial Sensitivity Tests; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D013845:Thienamycins / Q000008:administration & dosage* / Q000493:pharmacokinetics
D000900:Anti-Bacterial Agents; D013845:Thienamycins; D015378:Imipenem; D000077731:Meropenem