| A randomized trial of 7-day doripenem versus 10-day imipenem-cilastatin for ventilator-associated pneumonia. | |
| | |
MedLine Citation:
|
PMID: 23148736 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
ABSTRACT: INTRODUCTION: To compare a 7-day course of doripenem to a 10-day course of imipenem-cilastatin for ventilator-associated pneumonia (VAP) due to Gram-negative bacteria. METHODS: A prospective, double-blinded, randomized trial comparing a fixed 7-day course of doripenem 1 gram as a 4-hour infusion every 8 hours with a fixed 10-day course of imipenem-cilastatin 1 gram as a 1-hour infusion every 8 hours (April 2008 through June 2011). RESULTS: The study was stopped prematurely at the recommendation of the Independent Data Monitoring Committee that was blinded to treatment arm assignment and performed a scheduled review of data which showed signals that were close to the pre-specified stopping limits. The final analyses included 274 randomized patients. The clinical cure rate at the end of therapy (EOT) in the microbiological intent-to-treat (MITT) population was numerically lower for patients in the doripenem arm compared to the imipenem-cilastatin arm (45.6% versus 56.8%; 95% CI, -26.3% to 3.8%). Similarly, the clinical cure rate at EOT was numerically lower for patients with Pseudomonas aeruginosa VAP, the most common Gram-negative pathogen, in the doripenem arm compared to the imipenem-cilastatin arm (41.2% versus 60.0%; 95% CI, -57.2 to 19.5). All cause 28-day mortality in the MITT group was numerically greater for patients in the doripenem arm compared to the imipenem-cilastatin arm (21.5% versus 14.8%; 95% CI, -5.0 to 18.5) and for patients with Pseudomonas aeruginosa VAP (35.3% versus 0.0%; 95% CI, 12.6 to 58.0). CONCLUSIONS: Among patients with microbiologically confirmed late-onset VAP, a fixed 7-day course of doripenem was found to have non-significant higher rates of clinical failure and mortality compared to a fixed 10-day course of imipenem-cilastatin. Consideration should be given to treating patients with VAP for more than 7 days to optimize clinical outcome. Trial registration: clinicaltrials.gov NCT00589693. |
| | |
Authors:
|
Marin H Kollef; Jean Chastre; Marc Clavel; Marcos I Restrepo; Bart Michiels; Kone Kaniga; Iolanda Cirillo; Holly Kimko; Rebecca Redman |
Related Documents
:
|
23072686 - Treatment of gastric carcinoids type 1 with the gastrin receptor antagonist netazepide ... 23294066 - Minimally invasive treatment of pilonidal disease: crystallized phenol and laser depila... 11240316 - Delayed facial palsy after vestibular schwannoma surgery. 22955406 - Structural and biomechanical characteristics after early mobilization in an achilles te... 17990606 - Therapy of the empyema thoracis. why not thoracostoma? 23072686 - Treatment of gastric carcinoids type 1 with the gastrin receptor antagonist netazepide ... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-11-13 |
Journal Detail:
|
Title: Critical care (London, England) Volume: 16 ISSN: 1466-609X ISO Abbreviation: Crit Care Publication Date: 2012 Nov |
Date Detail:
|
Created Date: 2012-11-14 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9801902 Medline TA: Crit Care Country: - |
Other Details:
|
Languages: ENG Pagination: R218 Citation Subset: - |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Homogeneous nucleation of methane hydrates: unrealistic at realistic conditions.
Next Document: Gastrointestinal symptoms and psychological well-being in patients with microscopic colitis.