Wilson S E
Department of Surgery, California College of Medicine, Orange, USA.
Scand J Infect Dis Suppl. 1995;96:28-33.
Meropenem is the first of a new class of dehydropeptidase-stable carbapenems which is highly active against the microflora associated with intra-abdominal infection. Three randomised, prospective multicentre studies, have compared meropenem monotherapy with imipenem/cilastatin and cefotaxime plus metronidazole in the treatment of intra-abdominal infections: meropenem (1 g) versus cefotaxime (2 g) plus metronidazole (500 mg); meropenem (1 g) versus imipenem/cilastatin (1 g); meropenem (500 mg) versus imipenem/cilastatin (500 mg), all administered intravenously every 8 hours. Of the 641 patients with intra-abdominal infections randomised to treatment, 555 (87%) were clinically evaluable and 445 (69%) were bacteriologically evaluable. At the end of treatment a majority of the patients in each of the 3 studies was clinically cured or improved (91-100%). There were no clinically significant differences between the treatment regimens. Meropenem was effective over a range of intra-abdominal infections and as well tolerated as imipenem/cilastatin, and cefotaxime plus metronidazole.
美罗培南是新型的对脱氢肽酶稳定的碳青霉烯类药物中的首个品种，对与腹腔内感染相关的微生物群具有高度活性。三项随机、前瞻性多中心研究比较了美罗培南单一疗法与亚胺培南/西司他丁以及头孢噻肟加甲硝唑在治疗腹腔内感染方面的效果：美罗培南（1克）与头孢噻肟（2克）加甲硝唑（500毫克）；美罗培南（1克）与亚胺培南/西司他丁（1克）；美罗培南（500毫克）与亚胺培南/西司他丁（500毫克），均每8小时静脉给药一次。在随机接受治疗的641例腹腔内感染患者中，555例（87%）可进行临床评估，445例（69%）可进行细菌学评估。治疗结束时，三项研究中的大多数患者临床治愈或病情改善（91%-100%）。各治疗方案之间无临床显著差异。美罗培南对一系列腹腔内感染有效，耐受性与亚胺培南/西司他丁以及头孢噻肟加甲硝唑相当。
