Abstract |
We performed a prospective, open label, randomized study in intensive care unit patients with ventilator-associated pneumonia (VAP) to determine the efficacy and safety of empiric intravenous (i.v.) meropenem monotherapy compared with the combination of ceftazidime plus amikacin. A total of 140 patients receiving mechanical ventilation and diagnosed with pneumonia were included in the study. Patients were randomized to receive either 1 g meropenem i.v. every 8 hours or 2 g ceftazidime i.v. every 8 hours plus 15 mg/kg amikacin daily, administered to patients with normal renal function as two daily doses. Satisfactory clinical responses (cure or improvement) were achieved at the end of treatment in 68.1% of meropenem-treated patients and 54.9% in the ceftazidime/ amikacin treated group (relative risk 1.25; 95% confidence interval > 1.00, 1.55). When non-evaluable patients were excluded from the analysis, the satisfactory clinical response was 82.5% and 66.1% for the meropenem and ceftazidime/ amikacin patients, respectively (p = 0.044). Logistic regression demonstrated that treatment with meropenem and both the basic traumatic and medical pathologies were significantly associated with a satisfactory response. Adverse events judged to be possible or probably related to treatment were reported by seven (10.1%) patients in the meropenem group and by eight patients (11.3%) in the ceftazidime/ amikacin group. The results of this study confirm that monotherapy with meropenem is well tolerated and provides superior efficacy to the conventional combination of ceftazidime and amikacin in combating VAP.
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Authors | F Alvarez Lerma, Serious Infections Study Group |
Journal | Antibiotiki i khimioterapiia = Antibiotics and chemoterapy [sic]
(Antibiot Khimioter)
Vol. 46
Issue 12
Pg. 42-52
( 2001)
ISSN: 0235-2990 [Print] Russia (Federation) |
Vernacular Title | Effektivnost' monoterapii meropenemom pri ventiliator-assotsiirovannoĭ pnevmonii. |
PMID | 12108093
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)
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Chemical References |
- Thienamycins
- Amikacin
- Ceftazidime
- Meropenem
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Topics |
- Amikacin
(administration & dosage, adverse effects, therapeutic use)
- Ceftazidime
(administration & dosage, adverse effects, therapeutic use)
- Cross Infection
(drug therapy, microbiology, mortality)
- Drug Therapy, Combination
(administration & dosage, adverse effects, therapeutic use)
- Female
- Humans
- Male
- Meropenem
- Middle Aged
- Pneumonia, Bacterial
(drug therapy, microbiology, mortality)
- Prospective Studies
- Respiration, Artificial
(adverse effects, instrumentation)
- Superinfection
(drug therapy, etiology, mortality)
- Thienamycins
(adverse effects, therapeutic use)
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