Clinic for Pneumology and Rehabilitation, Heiligenschwendi, Switzerland.
J Antimicrob Chemother. 2012 Mar;67(3):661-5. doi: 10.1093/jac/dkr482. Epub 2011 Dec 16.
In this study the efficacy of doripenem, a new broad-spectrum carbapenem, was tested against an Escherichia coli strain and a Klebsiella pneumoniae strain in an experimental animal model. The comparator was cefepime monotherapy.
The rabbit meningitis model was used in this study and the penetration of doripenem through uninflamed and inflamed meninges was determined.
Doripenem, injected three times (75 mg/kg), led to serum peak levels around 100 mg/L and trough levels around 5 mg/L, resulting in a penetration rate of 14% through inflamed meninges and 7% through uninflamed meninges. Against K. pneumoniae, doripenem was slightly but not significantly more efficacious than cefepime over 8 h (5.40 ± 1.37 log(10) cfu/mL versus 3.59 ± 0.89 log(10) cfu/mL for cefepime). Also against the E. coli strain doripenem was slightly superior to the comparator (5.55 ± 0.87 log(10) cfu/mL versus 3.80 ± 1.10 log(10) cfu/mL for cefepime), although the difference was not significant.
Doripenem is a potential monotherapy for the treatment of meningitis due to Gram-negative microorganisms.
本研究旨在通过实验动物模型检测新型广谱碳青霉烯类药物多利培南对大肠杆菌和肺炎克雷伯菌的疗效。以头孢吡肟单药治疗作为对照。
本研究采用兔脑膜炎模型，测定多利培南穿过未感染和感染脑膜的渗透情况。
多利培南（75mg/kg，3 次注射）可使血清峰浓度达到 100mg/L 左右，谷浓度达到 5mg/L 左右，使感染脑膜的穿透率达到 14%，非感染脑膜的穿透率达到 7%。与头孢吡肟相比，多利培南在 8 小时内对肺炎克雷伯菌的疗效略好，但无统计学意义（多利培南 5.40±1.37log(10)cfu/mL，头孢吡肟 3.59±0.89log(10)cfu/mL）。对大肠杆菌株，多利培南也优于对照药物（多利培南 5.55±0.87log(10)cfu/mL，头孢吡肟 3.80±1.10log(10)cfu/mL），尽管差异无统计学意义。
多利培南可能是治疗革兰氏阴性菌引起的脑膜炎的一种单药治疗选择。
