TITLE

Meropenem: A Review of its Use in Patients in Intensive Care

AUTHOR(S)
Hurst, M.; Lamb, H.M.
PUB. DATE
March 2000
SOURCE
Drugs;Mar2000, Vol. 59 Issue 3, p653
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Meropenem is a carbapenem antibacterial agent that has antimicrobial activity against Gram-negative, Gram-positive and anaerobic micro-organisms. In vitro studies involving isolates from patients in intensive care units (ICUs) indicate that meropenem is more active against most Gram-negative pathogens than other comparators (including imipenem), although, compared with imipenem, meropenem is less active against most Gram-positive organisms. Resistance to meropenem is uncommon in most bacteria. Treatment with meropenem as initial empirical monotherapy was effective in a range of serious infections in adult and paediatric ICU patients. Meropenem monotherapy was as effective as imipenem/cilastatin in 4 comparative trials in terms of satisfactory clinical and bacteriological responses. Meropenem monotherapy was significantly more effective than ceftazidime-based combination treatments in 2 trials in patients with nosocomial lower respiratory tract infections (LRTIs) in terms of both clinical and bacteriological responses. Meropenem was also more active than ceftazidime-based treatments against both Gram-positive and Gram-negative organisms. However, 2 studies in patients with a range of serious infections found no significant differences between meropenem and cephalosporin-based treatments in terms of clinical or bacteriological response. Meropenem was also as effective as cephalosporin-based treatments in comparative trials in children with serious infections. Meropenem is well tolerated as either a bolus or an infusion, and clinical trials have shown similar incidences of adverse events to those observed with cephalosporin-based treatments. It is well tolerated by the CNS, with seizures reported infrequently, and can therefore be used at high doses and in patients with meningitis. The incidence of drug-related nausea and vomiting is low and, in contrast to imipenem/cilastatin, does not increase with dose or speed of administration. Conclusions: Meropenem is a well tolerated broad spectrum antibacterial agent that, when used as initial empirical monotherapy, is as effective as imipenem/cilastatin in the treatment of a range of serious infections (including nosocomial) in adults and children in ICUs. Compared with cephalosporin-based combination treatments, meropenem monotherapy may be more effective in the treatment of nosocomial LRTIs and can be used as monotherapy. Meropenem has an important role in the empirical treatment of serious infections in adults and children in ICUs.
ACCESSION #
9593099

 

Related Articles

  • Adjusting for time-varying confounding in the subdistribution analysis of a competing risk. Bekaert, Maarten; Vansteelandt, Stijn; Mertens, Karl // Lifetime Data Analysis;Mar2010, Vol. 16 Issue 1, p45 

    Despite decades of research in the medical literature, assessment of the attributable mortality due to nosocomial infections in the intensive care unit (ICU) remains controversial, with different studies describing effect estimates ranging from being neutral to extremely risk increasing....

  • ICU Acquired Weakness. Sung Won Na; Shin Ok Koh // Korean Journal of Critical Care Medicine;2011, Vol. 26 Issue 4, p203 

    Critical care has focused on recovery from acute organ failure and resuscitation. Neuromuscular abnormalities related to critical illness is not uncommon in critically ill patients, but ihey were relatively underestimated and unnoticed. Intensive care unit acquired weakness (ICUAW) leading to...

  • External ventricular and lumbar drainage-associated meningoventriculitis: prospective analysis of time-dependent infection rates and risk factor analysis. Scheithauer, S.; Bürgel, U.; Bickenbach, J.; Häfner, H.; Haase, G.; Waitschies, B.; Reinges, M.; Lemmen, S. // Infection;Jun2010, Vol. 38 Issue 3, p205 

    Data on time-dependency of external ventricular drainage (EVD)- and lumbar drainage (LD)-associated meningoventriculitis (MV) are scarce and discussions on the subject are controversial; no data exist for infection rates (IR) relative to drainage-days. For this reason, we conducted an...

  • The significance of demographic factors (age, sex, preoperative physiological status) and type of surgery on patients' outcome in ICU. KARLOVIĆ, ZORAN; PERIĆ, MATEO; VLADIĆ, DAJANA; KOSJERINA, ANITA; MAJERIĆ-KOGLER, VIŠNJA // Signa Vitae;Oct2013, Vol. 8 Issue 2, p42 

    The incidence of postoperative death has changed little in recent years. Most deaths occur in older patients with coexisting medical diseases who undergo major surgery. The objective of our research was to investigate the significance of demographic factors (age, gender, preoperational...

  • Catheter-associated urinary tract infection in a surgical intensive care unit. Mladenović, Jovan; Veljović, Milić; Udovičić, Ivo; Lazić, Srdjan; Jadranin, Željko; Šegrt, Zoran; Ristić, Petar; Šuljagić, Vesna // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;Oct2015, Vol. 72 Issue 10, p883 

    Background/Aim. Because patients in intensive care units usully have an urinary catheter, the risk of urinary tract infection for these patients is higher than in other patients. The aim of this study was to identify risk factors and causative microrganisms in patients with catheter-associated...

  • Use of linezolid in critically ill patients admitted to Intensive Care Units. Rodríguez, O.; Álvarez, F.; Oltra, R.; Cereijo, E.; Latorre, M. M.; Martínez, H. // Revista Española de Quimioterapia;2009, Vol. 22 Issue 2, p68 

    All indications of linezolid (LZD) in Intensive Care Units (ICU) were included as cases in an observational, prospective and multicentre study. One hundred thirty-nine indications were analyzed. In most cases (92.7%), treatment for nosocomial infections was indicated. The most frequent infection...

  • Nosocomial Infections and Agents Determined by Consultations in Intensive Care Unit. Büyüktuna, Seyit Ali; Turhan, Özge; Cengiz, Melike; Ramazanoğlu, Atilla; Yalçin, Ata Nevzat // Medical Journal of Trakya University / Trakya Universitesi Tip F;2010, Vol. 27 Issue 2, p150 

    Objectives: We investigated nosocomial infections diagnosed via consultations with the Department of Infectious Diseases and Clinical Microbiology at Reanimation I-II intensive care units. Patients and Methods: Of 3750 patients hospitalized at Reanimation I-II intensive care units, 1221 patients...

  • Nosocomial pneumonia in the ICU.  // People's Medical Society Newsletter;Jun96, Vol. 15 Issue 3, p5 

    Reports on a study which appeared in the March 20, 1996 issue of the `Journal of American Medical Association,' showing that nosocomial pneumonia independently contributed to the deaths of ICU patients. Incidence of higher death rates of ICU patients who develop nosocomial pneumonia; Factors...

  • Incidences of nosocomial infection in Uruguayan adult intensive care unit 2010. Guerra, S. E.; Albornoz, H.; Rosa, R.; Godino, M.; Camou, T.; Galiana, A.; Martinez, S.; Rios, G.; Rehermann, G.; Bagnulo, H. // BMC Proceedings;Jan2011 Supplement 6, Vol. 5, pP77 

    An abstract of the article "Incidences of nosocomial infection in Uruguayan adult intensive care unit 2010," by H. Albornoz, R. Rosa and M. Godino and colleagues, is presented.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics