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 Original Articles |
| Clinical Study of the Efficacy and Safety of Meropenem and Imipenem/Cilastatin for the Treatment of Urinary Tract Infections |
| Sae Woong Kim, Seung Ju Lee, Ji Yeol Lee, Yong Hyun Cho, Wan Sik Shin*, Moon Soo Yoon |
| Department of Urology, and Department of Internal Medicine*, College of Medicine, The Catholic University of Korea, Seoul, Korea |
Vol.17 Num.1 (p33~39)
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Background : Metopenem is the first of a new class carbapenems which may be administered without cilastatin. The clinical study was carried out to assess efficacy and safety of meropenem in the treatment of urinary tract infections, in comparison to imipenem/cilastatin.
Methods : This was a controlled, two-center, prospective, randomized study with two parallel groups. From October 1996 until February 1998, a total of 115 consecutive patients with urinary tract infections, such as pyeolonephritis and complicated cystitis, were randomly allocated into two groups, 58 in the meropenem group and 57 in the imipenem/cilastatin group. Both drugs were administered intravenously, at a dose of 0.5 g every 12 hours. The mean duration of therapy was 4 days (3-8 days) for both treatment. Clinical and bacteriological reponses were assessed at the begining of treatment, during treatment, at the end of treatment, and follow-up (1-2 weeks).
Results : A total of 67 patients, 34 of meropenem and 33 of imipenem/cilastatin, were evaluable for response. Overall, a positive clinical response (recovery and improvement) was observed in 32 (94.1%) of 34 patients treated with meropenem and in 29 (87.9%) of 33 patients with imipenem/cilastin and the corresponding eradication rates of the primary pathogens were 32 (94.1%) of 34 patients and 29 (87.9%) of 33 patients, respectively. The microbiological relapse after the treatment completion was recorded in 4 patients treated with meropenem and 7 patients given imipenem/cilastatin and superinfections occurred in none and 2 patients, respectively. No statistically significant differences in the clinical or bacteriological outcome were observed between the treatment groups. Both drugs were well tolerated with adverse events considered to be related to therapy being recorded for 1 (1.8%) of 56 patients treated with meropenem and 1 (1.9%) of 53 of those who had been given imipenem/cilastatin.
Conclusion : Empirical monotherapy with meropenem was therefore as effective and as well tolerated as that with imipenem/cilastatin for the treatment of urinary tract infections.
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Keywords : Meropenem, Imipenem/Cilastatin, Urinary tract infection |
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