Tsuda S, Nakai H, Murakami T, Seryu S, Takashima T, Tanaka S, Nakagawa H, Nishigaki H, Okuda T, Nishida K
Third Department of Internal Medicine, Kyoto Prefectural University of Medicine.
Jpn J Antibiot. 1991 Aug;44(8):886-98.
Imipenem/cilastatin sodium (IPM/CS), which has a broad spectrum of activity against both Gram-positive and -negative bacteria including methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, was used as the second choice for severe infections associated with hematological disorders. Sixty-five patients were treated with IPM/CS. Among them, 53 patients were evaluable for the clinical efficacy. Twelve patients were not evaluable due to the following reasons: 5 patients were treated with combinations of other regimens such as cefzonam, cefmenoxime, ciprofloxacin or gamma-globulin, 5 were patients to whom IPM/CS was administered as the first choice, and the remaining 2 patients were thought to be suffering not from febrile infections but from febrile tumor. Excellent responses were observed in 10 (18.9%) patients and good responses in 23 (43.4%) patients, with an overall rate of efficacy of 62.3%. The efficacy in septic patients was 75% (3/4), and that in patients whose peripheral granulocytes were continuously below 100/microliter was also 75% (6/8). Two patients who suffered from tumor fever and 5 patients who had received no chemotherapy before IPM/CS administration were included in the final evaluation of side effects. Side effects were observed in 16 patients (16/60, 26.7%). In a 61 years, female patient, a skin eruption was found 4 days after IPM/CS therapy was started. In 15 patients, mild gastrointestinal symptoms such as nausea and vomiting were identified within a few days after IPM/CS treatment was started. Abnormal laboratory data such as eosinophilia, liver dysfunction or renal dysfunction were also identified in 4 patients (4/60, 6.7%). Degrees of these abnormalities were very slight, however, and the continuation of treatment was not disturbed. These results indicated that IPM/CS was an effective second line regimen of chemotherapy for the treatment of severe infections in patients with hematological disorders.
亚胺培南/西司他丁钠（IPM/CS）对革兰氏阳性菌和阴性菌均有广泛的抗菌活性，包括耐甲氧西林金黄色葡萄球菌和铜绿假单胞菌，被用作血液系统疾病相关严重感染的二线治疗药物。65例患者接受了IPM/CS治疗。其中，53例患者可评估临床疗效。12例患者因以下原因不可评估：5例患者接受了其他治疗方案的联合治疗，如头孢唑南、头孢甲肟、环丙沙星或丙种球蛋白；5例患者将IPM/CS作为一线治疗药物；其余2例患者被认为不是发热性感染，而是发热性肿瘤。10例（18.9%）患者疗效极佳，23例（43.4%）患者疗效良好，总有效率为62.3%。败血症患者的有效率为75%（3/4），外周粒细胞持续低于100/微升的患者有效率也为75%（6/8）。2例肿瘤热患者和5例在IPM/CS给药前未接受化疗的患者被纳入副作用的最终评估。16例患者（16/60，26.7%）出现副作用。在一名61岁的女性患者中，IPM/CS治疗开始4天后出现皮疹。15例患者在IPM/CS治疗开始后数天内出现恶心、呕吐等轻度胃肠道症状。4例患者（4/60，6.7%）还出现了嗜酸性粒细胞增多、肝功能或肾功能异常等实验室数据异常。然而，这些异常程度非常轻微，并未干扰治疗的继续进行。这些结果表明，IPM/CS是治疗血液系统疾病患者严重感染的一种有效的二线化疗方案。
