Clinical efficacy and tolerance of
meropenem were estimated by comparison with those of
ceftazidime and
amikacin used in combination in the
therapy of
hospital infections of the lower respiratory tract, skin and soft tissues, intraabdominal and gynecologic
infections, urinary tract infection and
sepsis. 48 patients were given
meropenem in a dose of 1 g every 8 hours for 3-14 days (the average of 9 days). 47 patients were subjected to the routine combined
therapy:
ceftazidime in a dose of 1 g every 8 hours and
amikacin in a dose of 0.5 g every 12 hours for 2-14 days (the average of 9 days). The patient groups were comparable by the age, nature and severity of the
infection and the condition (the mean APACHE II of 9.1 and 8.9). By the end of the treatment a positive clinical effect (recovery and improvement) was observed in 47 patients (97.9 per cent) treated with
meropenem and in 41 patients (89.1 per cent) subjected to the combined
therapy. The
infection relapse within 4 weeks after the treatment completion was recorded in 3 patients in every group. Before the treatment 133 microbial strains were isolated from the patients. 121 of them were susceptible to
meropenem (91.1 per cent), 111 to
amikacin (83.4 per cent) and 90 to
ceftazidime (67.7 per cent). The difference between
meropenem and
ceftazidime was significant (p = 0.0005). Eradication of the primary pathogens at the background of the
meropenem therapy was stated in 41 out of 44 patients (93.2 per cent) and that of the combined
therapy in 38 out of 43 patients (88.4 per cent). The microbiological relapse after the treatment completion was recorded in 3 and 2 patients, respectively. Side effects were observed in 8.3 per cent of the patients treated with
meropenem and in 10.6 per cent of the patients subjected to the combined
therapy. The trial results were indicative of the
meropenem high efficacy and good tolerance and of the possible use of the
drug in the monotherapy as an alternative of the routine combined
therapy of severe
hospital infections.