Mayer M, Brand J, Schlenkhoff D, Opferkuch W
Infection. 1986;14 Suppl 2:S160-3. doi: 10.1007/BF01647502.
In a prospective study 43 patients (19 men, 24 women) suffering from severe bacterial infections such as peritonitis (n = 16), soft tissue infection (n = 12), pneumonia (n = 7), septicemia (n = 6), catheter sepsis (n = 2), cholangitis (n = 4), osteomyelitis (n = 3), complicated urinary tract infection (n = 2) or endocarditis (n = 1) were treated t. i. d. with short-time i. v. infusions of 0.5 g imipenem/cilastatin for five to 37 days (means = 9). All the patients were cured or significantly improved following therapy with imipenem/cilastatin alone or in combination with surgical intervention. The most frequent isolates were Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus faecalis. 58 (83%) of the 70 pathogens isolated initially were eliminated. The 12 microorganisms (gram-negative aerobic bacteria) which persisted were non-contributory to the course of the infection and had MICs between 0.32 and 4 mg/l. The MICs for 60 isolates were less than or equal to 1 mg/l; the MICs for nine isolates were in the range of 2 to 8 mg/l. One S. epidermidis isolate presented primary resistance to imipenem (MIC 16 mg/l). The tolerability was good. Phlebitis was observed in one case only. Based on our experience we conclude that monotherapy with imipenem/cilastatin at a dosage of 0.5 g t. i. d. is appropriate for the treatment of severe bacterial infections.
在一项前瞻性研究中，43例患者（19例男性，24例女性）患有严重细菌感染，如腹膜炎（n = 16）、软组织感染（n = 12）、肺炎（n = 7）、败血症（n = 6）、导管败血症（n = 2）、胆管炎（n = 4）、骨髓炎（n = 3）、复杂性尿路感染（n = 2）或心内膜炎（n = 1），每天3次接受0.5克亚胺培南/西司他丁的短期静脉输注治疗5至37天（平均9天）。所有患者在单独使用亚胺培南/西司他丁治疗或联合手术干预后均治愈或显著改善。最常见的分离菌为大肠埃希菌、铜绿假单胞菌、奇异变形杆菌、金黄色葡萄球菌、表皮葡萄球菌和粪肠球菌。最初分离出的70种病原体中有58种（83%）被清除。持续存在的12种微生物（革兰氏阴性需氧菌）对感染过程无影响，其最低抑菌浓度（MIC）在0.32至4毫克/升之间。60株分离菌的MIC小于或等于1毫克/升；9株分离菌的MIC在2至8毫克/升范围内。1株表皮葡萄球菌分离株对亚胺培南呈现原发性耐药（MIC 16毫克/升）。耐受性良好。仅1例观察到静脉炎。根据我们的经验，我们得出结论，每日3次0.5克剂量的亚胺培南/西司他丁单药治疗适用于严重细菌感染的治疗。
