title: Clinical efficacy and safety of high-dose doripenem in Japanese patients with pneumonia.
abstract: BACKGROUND
  Pneumonia is now the third leading cause of death in Japan, and the number of patients with pneumonia is expected to increase with the progression of aging of the country. Higher dosage of antibiotics has recently been used, and high-dose doripenem (DRPM; 3 g daily) was approved for use in Japan in April 2011. However, there is a lack of data regarding the efficacy and safety of high-dose DRPM in Japan. This study prospectively assessed the clinical efficacy and safety of high-dose DRPM in Japanese patients with refractory pneumonia.
  
  
  METHODS
  This study was performed at University of Occupational and Environmental Health, Japan and affiliated hospitals. The efficacy and safety of DRPM in patients with pneumonia treated with 3 g daily of DRPM, including those in whom DRPM dosage was increased from 1.5 g to 3 g daily, were evaluated.
  
  
  RESULTS
  The safety evaluations included 56 patients, and the efficacy was evaluated in 51 patients. DRPM (3 g daily) treatment showed the response rate of 92.2% (47/51). Adverse effects of DRPM (3 g daily) were observed in 11 of 56 patients (19.7%), and all of these patients improved after DRPM cessation. Two patients had to stop DRPM administration due to elevated aminotransferase levels. The efficacy of DRPM in patients with pneumonia in whom DRPM was increased from 1.5 g daily to 3 g daily was 84.6% (11/13).
  
  
  CONCLUSIONS
  High-dose DRPM (3 g daily) treatment is effective and relatively safe in Japanese patients with pneumonia.
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan. Electronic address: yatera@med.uoeh-u.ac.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yatera
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Naito
authors.affiliation: Department of Respiratory Medicine, Wakamatsu Hospital of University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Noguchi
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
authors.forename: Kentarou
authors.initials: K
authors.lastname: Akata
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Yamasaki
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
authors.forename: Chinatsu
authors.initials: C
authors.lastname: Nishida
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
authors.forename: Toshinori
authors.initials: T
authors.lastname: Kawanami
authors.affiliation: Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
authors.forename: Noriho
authors.initials: N
authors.lastname: Sakamoto
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kido
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishimoto
authors.affiliation: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan; Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mukae
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015780:Carbapenems / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000077726:Doripenem; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000453:epidemiology; D011446:Prospective Studies; D013183:Sputum / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D000077726:Doripenem
keywords: Carbapenem; Doripenem; Efficacy; High dose; Pneumonia; Safety