Intramuscular imipenem/cilastatin for treatment of mild and moderately severe bacterial infections.

The efficacy and safety of intramuscularly administered imipenem/cilastatin was studied in 70 patients with mild or moderately severe bacterial infections (skin and soft tissue infections, respiratory tract infections, urinary tract infections and pelvic infections). Doses of imipenem/cilastatin ranged from 0.5 to 0.75 g twice daily. Fifty-five patients were evaluable for bacteriological efficacy; in the remaining 15 patients no pathogens were isolated or susceptibility data were lacking. MIC50 and MIC90 of imipenem were 0.12 mg/l and 0.5 mg/l, respectively, for Gram-negative pathogens isolated and 0.25 mg/l and 0.5 mg/l, respectively, for Gram-positive pathogens. Only one strain (a Flavobacterium odoratum) was resistant to imipenem. Clinical cure and bacteriological elimination was achieved in 94% of evaluable patients while 3% showed marked clinical improvement. Two patients were considered therapeutic failures. No clinical adverse effects were noted. Abnormal liver transaminases were recorded in 23% of the patients and 11% developed eosinophilia. In no patient was imipenem/cilastatin discontinued due to adverse effects. It is concluded that intramuscular imipenem/cilastatin in these patients was well tolerated and efficacious.