Naber K G, Adam D, Bauernfeind A, Hönig E
Infection. 1986;14 Suppl 2:S122-9. doi: 10.1007/BF01647496.
Minimal inhibitory concentrations (MICs) of imipenem, ceftazidime, piperacillin, tobramycin, azthreonam and carumonam were assessed for 400 urinary isolates from hospitalized patients with complicated and/or nosocomial urinary tract infections yielding greater than or equal to 10(5) colony forming units (cfu). More than 90% of the gram-negative pathogens were sensitive to all the antibiotics tested. However, only imipenem and piperacillin exhibited MIC90 values in the therapeutic range for gram-positive pathogens (approximately half of which were staphylococci and enterococci). Perioperative prophylaxis with 0.5 g imipenem/cilastatin administered at different time intervals before the operation (up to six hours) was performed in patients undergoing resection (n = 31), respectively enucleation (n = 1) of a prostatic adenoma or lithotriptic treatment (n = 4). Imipenem yielded peak plasma concentrations of 12.2 to 134.8 mg/l (mean 49.4 mg/l). The estimated half life time in these patients was approximately three hours. Considerable intra as well as interindividual variations were found for imipenem concentrations in prostatic adenoma. However, they were sufficiently high to reach sensitive pathogens (MICs up to 1 mg/l) for up to two-and-a-half hours. Up to six hours after dosing the concentrations in prostatic secretions ranged between 1 and 2 mg/l. A total of 20 urological patients suffering from complicated urinary tract infections (15 men, five women) received a short-term i.v. infusion of 0.5 mg imipenem/cilastatin t.i.d. for seven to 16 days (median seven days). In all these patients urines were sterile during therapy as well as one to two days after therapy. Follow-up examinations performed seven to ten days after the end of treatment in 19 of these patients showed ten patients to be free of infection (55%); these patients were classified as success. Seven patients (37%) presented a relapse (same pathogen) and two patients (10%) a re-infection (different pathogen). Imipenem/cilastatin was well tolerated locally and systemically.
对400株来自患有复杂性和/或医院获得性尿路感染的住院患者的尿液分离菌进行了亚胺培南、头孢他啶、哌拉西林、妥布霉素、氨曲南和卡芦莫南的最低抑菌浓度（MIC）评估，这些分离菌产生的菌落形成单位（cfu）大于或等于10⁵。超过90%的革兰氏阴性病原体对所有测试抗生素敏感。然而，只有亚胺培南和哌拉西林对革兰氏阳性病原体的MIC90值在治疗范围内（其中约一半为葡萄球菌和肠球菌）。对接受前列腺腺瘤切除术（n = 31）、摘除术（n = 1）或碎石治疗（n = 4）的患者，在手术前不同时间间隔（最长6小时）给予0.5 g亚胺培南/西司他丁进行围手术期预防。亚胺培南的血浆峰值浓度为12.2至134.8 mg/l（平均49.4 mg/l）。这些患者的估计半衰期约为3小时。在前列腺腺瘤中，发现亚胺培南浓度存在相当大的个体内和个体间差异。然而，它们足够高，足以在长达两个半小时内达到敏感病原体（MIC高达1 mg/l）。给药后6小时内，前列腺分泌物中的浓度在1至2 mg/l之间。共有20名患有复杂性尿路感染的泌尿外科患者（15名男性，5名女性）接受了为期7至16天（中位数7天）的0.5 mg亚胺培南/西司他丁静脉滴注，每日3次。在所有这些患者中，治疗期间以及治疗后1至2天尿液均无菌。对其中19名患者在治疗结束后7至10天进行的随访检查显示，10名患者无感染（55%）；这些患者被归类为成功。7名患者（37%）出现复发（相同病原体），2名患者（10%）出现再感染（不同病原体）。亚胺培南/西司他丁在局部和全身耐受性良好。
