PANIPENEM/BETAMIPRON IN THE TREATMENT OF PATIENTS WITH SURGICAL INFECTIONS

• Published in: CHEMOTHERAPY Vol. 39; no. Supplement3; pp. 572 - 584
• Main Authors: Morimoto, Ken, Kinoshita, Hiroaki, Nakatani, Shuichi, Sakai, Katsuji, Fujimoto, Mikio, Ohno, Kohichi, Ueda, Takami, Hirata, Sanae, Muramatsu, Hideki, Mizugami, Kenji, Morimoto, Yuzuru, Ohmori, Kunio
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Chemotherapy 20-09-1991
• Subjects: Carbapenems; Panipenem/betamipron
• ISSN: 0009-3165; 1884-5894
• DOI: 10.11250/chemotherapy1953.39.Supplement3_572

We gave panipenem/betamipron to 3 patients during percutaneous transhepatic cholangiodrainage (PTCD) for bile study, and 2 patients of cholecystectomy for tissue level study, and studied the pharmacokinetics of the drug. We treated 28 surgical infections with the same drug and evaluated its clinical efficacy. In the pharmacokinetic study, 0.5g/0.5g was given intravenously. The peak levels in the plasma, 22.7-35.1μg/ml, were at 0.5 hour. The peak levels in the bile, 3.77-8.23μ/ml, were at 1-4 hours, decreasing to 0.16-0.74μg/ml at 6-8 hours. The levels of the drug for gall bladder bile 1.20μg/ml and below the measurable level, common bile duct bile 5.24 and 3.28μg/ml, and gall bladder wall, 16.0 and 12.5μg/ml, were at cholecystectomy. Of the 26 surgical infections, the clinical efficacy of the drug was excellent 14, good in 10, fair in 1, and poor in 1, with an efficacy rate of 92%. The bacteriological response was evaluated in 14 of the 28 infections. The bacteria were eradicated in 9 patients, decreased in 1 patient, replaced in 2 patients, and persisted in 2 patients, with an eradication rate of 79%. The bacteriological responses for isolated organisms were evaluated in 22 strains. Nineteen strains were eradicated, and 3 strains were persisted. The MIC levels were examined 21 bacterial strains isolated. For the 3 isolates of Staphylococcus aureus, and for the 1 isolate of Enterococcus faecium, the MIC levels were 12.5μg/ml or more. A decrease of hemoglobin level for 1 patient and an elevation of the transaminase for 3 patients were observed.