Imipenem/cilastatin (1.5 g daily) versus meropenem (3.0 g daily) in patients with intra-abdominal infections: results of a prospective, randomized, multicentre trial

Scand J Infect Dis. 1997;29(5):503-8. doi: 10.3109/00365549709011863.

Abstract

An open-label prospective, randomized, parallel multicentre study was undertaken to compare the efficacy and tolerability of 1.5 g/day intravenous imipenem/cilastatin with 3 g/day intravenous meropenem in the treatment of intra-abdominal infections. A total of 287 patients were enrolled: 201 patients, divided between the 2 treatment groups, were evaluable. Clinical outcome, bacteriological outcome, untoward microbiological effects, and clinical and laboratory adverse experiences were evaluated. 98% of patients receiving imipenem/cilastatin therapy were cured, with 96% showing eradication of infection. 95% of those on meropenem were cured, with 98% showing eradication. These differences in clinical and bacteriological outcome between the 2 treatments were not statistically significant. Two patients receiving imipenem/cilastatin and 5 receiving meropenem had untoward microbiological effects. There was a 0.7% frequency (1/139 patients) of possibly or probably drug-related clinical or laboratory adverse experiences with imipenem/cilastatin and a 2.7% frequency (4/148) with meropenem. The mean time to defervescence was significantly less for patients in the imipenem/cilastatin treatment group than for those receiving meropenem. This study shows that 1.5 g/day of imipenem/cilastatin is equivalent to 3.0 g/day meropenem in clinical and bacteriological outcome, as well as in incidence of side effects.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • APACHE
  • Abdomen*
  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Infections / drug therapy*
  • Cilastatin / administration & dosage
  • Cilastatin / therapeutic use*
  • Female
  • Humans
  • Imipenem / administration & dosage
  • Imipenem / therapeutic use*
  • Infusions, Intravenous
  • Male
  • Meropenem
  • Middle Aged
  • Prospective Studies
  • Protease Inhibitors / administration & dosage
  • Protease Inhibitors / therapeutic use*
  • Thienamycins / administration & dosage
  • Thienamycins / therapeutic use*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Protease Inhibitors
  • Thienamycins
  • Cilastatin
  • Imipenem
  • Meropenem