Eighteen patients in a neurosurgery intensive care unit who had nosocomial pneumonia and/or bacteremia were treated with imipenem/cilastatin. The 16 patients who were evaluable had pneumonia; 4 of these had concurrent bacteremia. Eleven patients had a satisfactory clinical response (69 percent) and all patients with positive blood cultures had the organism eradicated. There were 44 organisms isolated from the initial culture of bronchial secretion and 32 of these organisms were gram-negative bacilli (72.5 percent). One patient with pneumonia who initially had Pseudomonas aeruginosa sensitive to imipenem developed resistance during therapy. Adverse effects were minimal; one case of nausea occurred, which was thought to be related to a short infusion time. The most prominent laboratory abnormality was an increase in platelet count, seen in 50 percent of treated patients.
Albers-SchonbergGArisonBHHensensODStructure and absolute configuration of thienamycin. J Am Chem Soc1978; 100: 6491–9.
2.
ChristensenBG. Structure-activity relationships in beta-lactam antibiotics. In: SaltonMRJShockmanGD, eds. Beta-lactam antibiotics: mode of action, new developments, and future prospects. New York: Academic Press, 1981: 101–22.
3.
KahanFMKroppHSundelofJG. Birnbaum j. Thienamycin: development of imipenem-cilastatin. J Antimicrob Chemother1983; 12 (suppl D): 1–35.
4.
SandersCC. Novel resistance selected by the new expanded-spectrum cephalosporins: a concern. J Infect Dis1983; 147: 585–9.
SandersCCSandersWE. Emergence of resistance during therapy with the newer beta-lactam antibiotics: role of inducible beta-lactamases and implications for the future. Rev Infect Dis1983; 5: 639–48.
7.
TodaMSatoKNakazawaHMitsuhashiS. Effect of N-formimidoyl thienamycin (MK0787) on beta-lactamases and activity against beta-lactamase-producing strains. Antimicrob Agents Chemother1980; 18: 837–8.
8.
VuyeA. In vitro activity and beta-lactamase stability of N-formimidoyl thienamycin compared to that of second and third generation cephalosporins. Chemotherapy1982; 28: 267–75.
9.
KroppHSundelofJGKahnJSKahanFMBirnbaumJ. MK0787 (N-formimidoyl thienamycin): evaluation of in vitro and in vivo activities. Antimicrob Agents Chemother1980; 17: 993–1000.
10.
NorrbySRAlestigKBjornegardBUrinary recovery of N-formimidoyl (MK0787) as affected by coadministration of N-formimidoyl thienamycin dehydropeptidase inhibitors. Antimicrob Agents Chemother1983; 23: 300–7.
11.
NorrbySRAlestigKFerberFPharmacokinetics and tolerance of N-formimidoyl thienamycin (MK0787) in humans. Antimicrob Agents Chemother1983; 23: 293–9.
12.
NorrbySRBjornegardBFerberFJonesKH. Pharmacokinetics of imipenem in healthy volunteers. J Antimicrob Chemother1983; 12 (suppl D): 109–24.
13.
CullmanWOpferkuchWStieglitzMUlrichW. A comparison of the antibacterial activities of N-formimidoyl thienamycin (MK0787) with those of other recently developed beta-lactam derivatives. Antimicrob Agents Chemother1982; 22: 302–7.
14.
MitsuhashiS. In vitro and in vivo antibacterial activity of imipenem against clinical isolates of bacteria. J Antimicrob Chemother1983; 12 (suppl D): 53–64.
15.
TallyFPJacobusNVGorbachSL. In vitro activity of N-formimidoyl thienamycin (MK0787). Antimicrob Agents Chemother1978; 18: 642–4.
16.
WeaverSSBodeyGPLeblancBM. Thienamycin: new beta-lactam antibiotic with potent broad-spectrum activity. Antimicrob Agents Chemother1979; 15: 518–21.
17.
BaumgartnerJDGlauserMP. Comparative study of imipenem in severe infections. J Antimicrob Chemother1983; 12 (suppl D): 141–8.
18.
CalandraGBRicciFMWangCSafety and tolerance comparison of imipenem-cilastatin to cephalothin and cefazolin. J Antimicrob Chemother1983; 12 (suppl D): 125–31.
19.
EronLJHixonDLParkCHGoldenbergRIPoretzDM. Imipenem versus moxalactam in the treatment of serious infections. Antimicrob Agents Chemother1983; 24: 841–6.
20.
MarierRLMcCloskeyRVDickensonGComparative clinical trial of imipenem-cilastatin (N-formimidoyl thienamycin-dehydroxypeptidase inhibitor) and cefazolin. J Antimicrob Chemother1983; 12 (suppl D): 133–9.
21.
RappRPYoungBFosterTSTibbsPAO'NealW. Ceftazidime versus tobramycin/ticarcillin in treating hospital acquired pneumonia and bacteremia. Pharmacotherapy1984; 4: 211–5.
22.
RibnerBSRaederRHollsteinMFreimerEH. A randomized study comparing clinical efficacy and safety of thienamycin formamidine (MK0787)/renal dipeptidase inhibitor (MK0791) and cefazolin. J Antimicrob Chemother1983; 12: 387–91.
