title: Open-label study to evaluate the pharmacodynamics, clinical efficacy, and safety of meropenem for adult bacterial meningitis in Japan.
abstract: The aim of this study was to assess the efficacy, safety, and concentration of meropenem in cerebrospinal fluid when meropenem (2 g every 8 h) was administered to Japanese adult patients with bacterial meningitis. Five Japanese patients (mean age 60.6 years [range 35-71]) were enrolled. Infection with Streptococcus pneumoniae (three patients), Streptococcus salivarius (one patient), and Staphylococcus aureus (one patient) was confirmed by cerebrospinal fluid culture. Meropenem (2 g every 8 h) was administered to all five patients. Treatment duration ranged from 14 to 28 days (mean 22.6 days). All the patients were successfully treated. The concentration of meropenem in cerebrospinal fluid ranged from 0.27 to 6.40 μg/ml up to 8.47 h and was over 1 μg/ml 3 h after starting meropenem infusion. In each patient, the present study confirmed for the first time that the concentration of meropenem in cerebrospinal fluid exceeded the minimal inhibitory concentration for these pathogens. Eleven clinical and laboratory adverse events considered to be related to meropenem were observed in all patients, but no serious adverse event and no discontinuance of treatment due to adverse events occurred. Thus meropenem appeared to be a well-tolerated and effective agent for Japanese adult patients with bacterial meningitis. 2 g every 8 h of meropenem was delivered to CSF and its concentration was exceed in MICs for the detected pathogens.
authors.affiliation: Division of Neurology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Morita
authors.affiliation: Division of Neurology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan. Electronic address: kamei.satoshi@nihon-u.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kamei
authors.affiliation: Division of Neurology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Minami
authors.affiliation: Department of Neurology, Asahikawa Red Cross Hospital, Asahikawa, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Neurology, Asahikawa Red Cross Hospital, Asahikawa, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawabata
authors.affiliation: Department of Neurology, Tohoku University Hospital, Sendai, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kuroda
authors.affiliation: Department of Neurology, National Hospital Organization Sendai Medical Center, Sendai, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Neurology, Saitama Medical University Hospital, Saitama, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Araki
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Iwasaki
authors.affiliation: Department of Neurology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
authors.forename: Rei
authors.initials: R
authors.lastname: Kobayashi
authors.affiliation: Department of Neurology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Hayashi
authors.affiliation: Department of Neurology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
authors.forename: Tetsuyuki
authors.initials: T
authors.lastname: Hirayama
authors.affiliation: Department of Neurology, Nagoya Ekisaikai Hospital, Nagoya, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Ochiai
authors.affiliation: Department of Neurology, Nagoya Ekisaikai Hospital, Nagoya, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Ueda
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Yamagishi
authors.affiliation: Department of Neurology, Aichi Medical University Hospital, Aichi, Japan.
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Niwa
authors.affiliation: Department of Neurology, Kurashiki Central Hospital, Kurashiki, Japan.
authors.forename: Katsuro
authors.initials: K
authors.lastname: Shindo
authors.affiliation: Division of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Fukushima
authors.affiliation: Department of Neurology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Takita
authors.affiliation: Clinical Development II, Dainippon Sumitomo Pharma Co., Ltd, Tokyo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Neurology, Kohnan Hospital, Sendai, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Sato
authors.affiliation: Department of Clinical Infectious Diseases, Aichi Medical University Graduate School of Medicine, Aichi, Japan.
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Mikamo
authors.affiliation: Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iwata
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000382:microbiology; D000077731:Meropenem; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000382:microbiology; D013210:Staphylococcus / Q000187:drug effects*; D013845:Thienamycins / Q000009:adverse effects* / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D000077731:Meropenem
keywords: Adult; Bacterial meningitis; Efficacy; Japanese; Meropenem; Safety