Abstract
Imipenem-cilastatin was evaluated for efficacy and toxicity as an antistaphylococcal agent in 23 patients; 11 of these patients were infected with methicillin-resistant Staphylococcus aureus (MRSA), and 12 were infected with methicillin-susceptible S. aureus (MSSA). There were 15 soft tissue, 5 endovascular, and 3 skeletal infections and a total of nine patients with bacteremia. As determined by in vitro susceptibility testing, the MICs for 90% of the MRSA and MSSA isolates tested were 6.25 and 0.39 micrograms/ml, respectively. Two MRSA isolates were resistant to a concentration of greater than 16 micrograms/ml. When 11 MRSA isolates and 7 MSSA isolates were incubated for 48 h the MICs for 90% of the isolates increased to greater than 50 micrograms/ml for the MRSA isolates and 6.25 micrograms/ml for the MSSA isolates. Three S. aureus isolates emerged resistant. Ten of 11 (91%) MRSA infections and 11 of 12 (92%) MSSA infections were clinically cured. Adverse reactions occurred in 25% of the imipenemcilastatin-treated patients. These reactions included gastrointestinal intolerance (7% of the patients), rash or pruritis (6%), eosinophilia (6%), thrombocytosis (4%), and a positive, direct Coomb test without hemolysis (3%). One of the two patients for whom therapy was discontinued because of gastrointestinal intolerance had antibiotic-associated colitis. Imipenem appears to be an effective antistaphylococcal agent against both MRSA and MSSA infections.
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Selected References
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- Acar J. F., Goldstein F. W., Kitzis M. D., Gutmann L. Activity of imipenem on aerobic bacteria. J Antimicrob Chemother. 1983 Dec;12 (Suppl 500):37–45. doi: 10.1093/jac/12.suppl_d.37. [DOI] [PubMed] [Google Scholar]
- Baumgartner J. D., Glauser M. P. Comparative imipenem treatment of Staphylococcus aureus endocarditis in the rat. J Antimicrob Chemother. 1983 Dec;12 (Suppl 500):79–87. doi: 10.1093/jac/12.suppl_d.79. [DOI] [PubMed] [Google Scholar]
- Cherubin C. E., Corrado M. L., Sierra M. F., Gombert M. E., Shulman M. Susceptibility of gram-positive cocci to various antibiotics, including cefotaxime, moxalactam, and N-formimidoyl thienamycin. Antimicrob Agents Chemother. 1981 Oct;20(4):553–555. doi: 10.1128/aac.20.4.553. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Díez Enciso M., Mateos Lindemann M., Gutiérrez Altés A. In vitro evaluation of N-formimidoyl thienamycin (MK0787) combined with amikacin against gram-negative bacilli and Staphylococcus aureus. Antimicrob Agents Chemother. 1982 Dec;22(6):1064–1066. doi: 10.1128/aac.22.6.1064. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Eron L. J., Hixon D. L., Park C. H., Goldenberg R. I., Poretz D. M. Imipenem versus moxalactam in the treatment of serious infections. Antimicrob Agents Chemother. 1983 Dec;24(6):841–846. doi: 10.1128/aac.24.6.841. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Haley R. W., Hightower A. W., Khabbaz R. F., Thornsberry C., Martone W. J., Allen J. R., Hughes J. M. The emergence of methicillin-resistant Staphylococcus aureus infections in United States hospitals. Possible role of the house staff-patient transfer circuit. Ann Intern Med. 1982 Sep;97(3):297–308. doi: 10.7326/0003-4819-97-3-297. [DOI] [PubMed] [Google Scholar]
- Imipenem/cilastatin versus gentamicin/clindamycin for treatment of serious bacterial infections. Report from a Scandinavian Study Group. Lancet. 1984 Apr 21;1(8382):868–871. [PubMed] [Google Scholar]
- Kahan F. M., Kropp H., Sundelof J. G., Birnbaum J. Thienamycin: development of imipenen-cilastatin. J Antimicrob Chemother. 1983 Dec;12 (Suppl 500):1–35. doi: 10.1093/jac/12.suppl_d.1. [DOI] [PubMed] [Google Scholar]
- Levine D. P., Cushing R. D., Jui J., Brown W. J. Community-acquired methicillin-resistant Staphylococcus aureus endocarditis in the Detroit Medical Center. Ann Intern Med. 1982 Sep;97(3):330–338. doi: 10.7326/0003-4819-97-3-330. [DOI] [PubMed] [Google Scholar]
- Marier R. L., McCloskey R. V., Dickenson G., Sanders C. V., Aldridge K. E., Hoffman T., Gutterman D., Janney A. Comparative clinical trial of imipenem-cilastatin (N-formimidoyl-thienamycin-dehydropeptidase inhibitor) and cefazolin. J Antimicrob Chemother. 1983 Dec;12 (Suppl 500):133–139. doi: 10.1093/jac/12.suppl_d.133. [DOI] [PubMed] [Google Scholar]
- Markowitz N., Pohlod D. J., Saravolatz L. D., Quinn E. L. In vitro susceptibility patterns of methicillin-resistant and-susceptible Staphylococcus auerues strains in a population of parenteral drug abusers from 1972 to 1981. Antimicrob Agents Chemother. 1983 Mar;23(3):450–457. doi: 10.1128/aac.23.3.450. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mitsuhashi S. In-vitro and in-vivo antibacterial activity of imipenem against clinical isolates of bacteria. J Antimicrob Chemother. 1983 Dec;12 (Suppl 500):53–64. doi: 10.1093/jac/12.suppl_d.53. [DOI] [PubMed] [Google Scholar]
- Saravolatz L. D., Markowitz N., Arking L., Pohlod D., Fisher E. Methicillin-resistant Staphylococcus aureus. Epidemiologic observations during a community-acquired outbreak. Ann Intern Med. 1982 Jan;96(1):11–16. doi: 10.7326/0003-4819-96-1-11. [DOI] [PubMed] [Google Scholar]
- Scheld W. M., Keeley J. M. Imipenem therapy of experimental Staphylococcus aureus and Streptococcus faecalis endocarditis. J Antimicrob Chemother. 1983 Dec;12 (Suppl 500):65–78. doi: 10.1093/jac/12.suppl_d.65. [DOI] [PubMed] [Google Scholar]
- Tally F. P., Jacobus N. V. Susceptibility of anaerobic bacteria to imipenem. J Antimicrob Chemother. 1983 Dec;12 (Suppl 500):47–51. doi: 10.1093/jac/12.suppl_d.47. [DOI] [PubMed] [Google Scholar]
- Thompson R. L., Fisher K. A., Wenzel R. P. In vitro activity of N-formimidoyl thienamycin and other beta-lactam antibiotics against methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 1982 Feb;21(2):341–343. doi: 10.1128/aac.21.2.341. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Verbist L., Verhaegen J. In vitro activity of N-formimidoyl thienamycin in comparison with cefotaxime, moxalactam, and ceftazidime. Antimicrob Agents Chemother. 1981 Mar;19(3):402–406. doi: 10.1128/aac.19.3.402. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wise R., Andrews J. M., Patel N. N-formimidoyl-thienamycin a novel beta-lactam: an in-vitro comparison with other beta-lactam antibiotics. J Antimicrob Chemother. 1981 May;7(5):521–529. doi: 10.1093/jac/7.5.521. [DOI] [PubMed] [Google Scholar]
- Witte J. L., Sapico F. L., Canawati H. N. In vitro susceptibility of methicillin-resistant and methicillin-susceptible Staphylococcus aureus strains to N-formimidoyl thienamycin. Antimicrob Agents Chemother. 1982 Nov;22(5):906–908. doi: 10.1128/aac.22.5.906. [DOI] [PMC free article] [PubMed] [Google Scholar]
