Document Detail


Combined imipenem/cilastatin and tobramycin therapy of multiresistant Pseudomonas aeruginosa in cystic fibrosis.
MedLine Citation:
PMID:  3104273     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ten patients with cystic fibrosis (CF) and chronic broncho-pulmonary Pseudomonas aeruginosa infection were given imipenem/cilastatin (100 mg/kg/day) in combination with tobramycin (15 mg/kg/day). Forced vital capacity and forced expiratory volume in the first second improved significantly in nine out of ten patients, and most of the patients improved clinically. P. aeruginosa was not eradicated in any patient and resistance against imipenem developed in all patients during treatment. A concomitant increase in MIC of piperacillin and ceftazidime occurred during treatment. In-vitro bactericidal synergy of imipenem and tobramycin was noted in 57% of pretreatment isolates. Seven patients complained of adverse reactions, mainly gastrointestinal, and treatment of three patients was discontinued after 5, 8, and 12 days of therapy, because of rash or nausea and vomiting. The side effects were considered to be due to imipenem/cilastatin. Because of the rapid development of imipenem resistance despite combination therapy, the high proportion of side effects, and the risk of induction of beta-lactam resistance, imipenem/cilastatin cannot be recommended for routine treatment of CF-patients with P. aeruginosa infection.
Authors:
S S Pedersen; T Pressler; T Jensen; V T Rosdahl; M W Bentzon; N Høiby; C Koch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of antimicrobial chemotherapy     Volume:  19     ISSN:  0305-7453     ISO Abbreviation:  J. Antimicrob. Chemother.     Publication Date:  1987 Jan 
Date Detail:
Created Date:  1987-05-21     Completed Date:  1987-05-21     Revised Date:  2009-10-28    
Medline Journal Info:
Nlm Unique ID:  7513617     Medline TA:  J Antimicrob Chemother     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  101-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anti-Bacterial Agents / metabolism,  pharmacology,  therapeutic use
Bronchopneumonia / complications,  drug therapy*
Child
Chronic Disease
Cilastatin
Cyclopropanes / metabolism,  pharmacology,  therapeutic use
Cystic Fibrosis / complications*
Drug Combinations / metabolism,  pharmacology,  therapeutic use
Drug Synergism
Drug Therapy, Combination
Female
Humans
Imipenem
Kinetics
Male
Microbial Sensitivity Tests
Penicillin Resistance
Piperacillin / pharmacology
Pseudomonas Infections / complications,  drug therapy*,  microbiology
Pseudomonas aeruginosa / drug effects
Sputum / microbiology
Thienamycins / metabolism,  pharmacology,  therapeutic use
Tobramycin / metabolism,  therapeutic use*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Cyclopropanes; 0/Drug Combinations; 0/Thienamycins; 32986-56-4/Tobramycin; 61477-96-1/Piperacillin; 74431-23-5/Imipenem; 82009-34-5/Cilastatin; 92309-29-0/cilastatin, imipenem drug combination

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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