Imipenem/cilastatin in the treatment of obstetric and gynecologic infections

Berkeley, Alan S.; Freedman, Karen; Hirsch, J.; Ledger, William J.

doi:10.1016/0002-9343(85)90105-6

Cited by 28 publications

(8 citation statements)

References 19 publications

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“…Imipenem (IPM) is an antibiotic used to treat severe infections of all body systems (3,18,32), particularly lower pulmonary infections (1). It is frequently used in intensive care units for the treatment of nosocomial infections (6).…”

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confidence: 99%

Microdialysis Study of Imipenem Distribution in Skeletal Muscle and Lung Extracellular Fluids of Noninfected Rats

Marchand

Dahyot

Lamarche

et al. 2005

Antimicrob Agents Chemother

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The aim of this study was to investigate the imipenem distribution in muscle and lung interstitial fluids by microdialysis in rats and to compare the free concentrations in tissue with the free concentrations in blood. Microdialysis probes were inserted into the jugular vein, hind leg muscle, and lung. Imipenem recoveries in these three media were determined in each rat by retrodialysis by drug period before drug administration. Imipenem was infused intravenously at a dose of 120 mg · kg ؊1 over 30 min, and microdialysis samples were collected for 150 min. The whole study was conducted with nonhydrated rats (n ‫؍‬ 4) and hydrated rats (n ‫؍‬ 6) while the animals were under isoflurane anesthesia. The decay of free concentrations in blood, muscle, and lung with time were monoexponential; and the concentration profiles in these three media were virtually superimposed in both groups. Accordingly, the ratios of the area under the curve (AUC) for tissue (muscle or lung) to the AUC for blood were always virtually equal to 1. Compared to values previously determined with awake rats, clearance was reduced by 2 and 1.5 in nonhydrated and hydrated rats, respectively, but the volume of distribution was unchanged. By combining microdialysis in blood and tissues, it was possible to demonstrate that free imipenem concentrations were virtually identical in blood, muscle, and lung.

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confidence: 99%

Microdialysis Study of Imipenem Distribution in Skeletal Muscle and Lung Extracellular Fluids of Noninfected Rats

Marchand

Dahyot

Lamarche

et al. 2005

Antimicrob Agents Chemother

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“…It is active against a broad spectrum of bacteria, including all the common members of the family Enterobacteriaceae (MIC < 1.3 iLg/ml) and staphylococci (MIC < 2 pgfml) (20), as well as Listeria monocytogenes (MIC for 90% of strains = 0.11 ig/ml [4]; MIC < 0.25 ,.g/ml [8]), Neisseria gonoeae (MIC for 90% of strains < 0.30 i&g/ml [4]; MIC = 0.01 to 0.1 p,g/ml [3]), Chlamydia trachomatis (3), and Bacteroides fi-agilis (MIC for 90% of strains = 0.25 pg/ml) (5). There appear to be three previous studies on imipenem in the perinatal period.…”

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confidence: 99%

Pharmacokinetics and transplacental passage of imipenem during pregnancy

Heikkilä

Renkonen

Erkkola

1992

Antimicrob Agents Chemother

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were studied in ea prean (n = 7; length of gestation, 8.6 1.5 weeks, mean drd deviaton), in late preg y (n = 7; length of gestation, 38.7 ± 1.4 weeks), and In the nonpregnant state (n = 6). A It has been confirmed that for many antibiotics, such as ampicillin and piperacillin, the pharmacokinetics alter and elimination is enhanced during pregnancy (10,16). This applies especially for polar drugs, and in general, the higher the water solubility of a drug is, the more its half-life is shortened during prepancy, while the reverse is true for lipid-soluble drugs (18). However, the pharmacokinetic behavior of a drug during pregnancy does not stick to the model predicted by the physicochemical properties only, as demonstrated in our previous study on the pharmacokinetics of medillinam (11).Imipenem is a fairly new carbapenem beta-lactam antibiotic which is clinically used in a 1:1 combination with cilastatin, a competitive inhibitor of dehydropeptidase, minimizing the renal metabolism of imipenem (2, 15). It is active against a broad spectrum of bacteria, including all the common members of the family Enterobacteriaceae (MIC < 1.3 iLg/ml) and staphylococci (MIC < 2 pgfml) (20), as well as Listeria monocytogenes (MIC for 90% of strains = 0.11 ig/ml [4]; MIC < 0.25 ,.g/ml [8]), Neisseria gonoeae (MIC for 90% of strains < 0.30 i&g/ml [4]; MIC = 0.01 to 0.1

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“…Today it is an established fact that the majority of pelvic infections encountered in obstetrics and gynecol ogy are caused by mixed aerobic and anaerobic bacteria that are indigenous to the lower genital tract [1,2]. Fur thermore, the importance of chlamydia in the pathogen esis of PID is well documented.…”

Section: Discussionmentioning

confidence: 99%

“…Because of the potential toxicity of such com binations emphasis has recently been placed on single agent therapy. Many of the second-and third-generation cephalosporins have been proposed for empiric, single agent therapy of these infections because of their in creased anaerobic and gram-negative coverage [1,2]. The present study was undertaken to compare single agent therapy of the two third-generation cephalosporins ceftriaxone and cefotaxime for the treatment of pelvic infections.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Ceftriaxone (1 × 1 g/Day) versus Cefotaxime (3 × 1 g/Day) for Gynecologic and Obstetric Infections

Gj¹

1990

Gynecol Obstet Invest

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A prospective, randomized clinical trial was conducted to compare the efficacy and tolerance of a single dose of 1 g ceftriaxone i.v. daily with 3 doses of 1 g cefotaxime i.v. daily for obstetric and gynecologic infections. Both agents are characterized by a wide spectrum and potent activity. Furthermore, ceftriaxone has an outstanding serum half-life of 8 h. 41 patients with pelvic inflammatory disease, pelvic or wound infections after vaginal or abdominal hysterectomy, endomyometritis and urinary-tract infection were included. Patients were monitored clinically by routine laboratory methods (erythrocyte sedimentation rate, white blood cell count and cross-reacting protein) and bacteriologically. Clinical parameters of infection were fever, local pain and/or tenderness, a sactosalpinx or pyosalpinx at palpation and cervical secretion. Clinical cure was achieved in 77.3% in the ceftriaxone and in 78.9% in the cefotaxime group, improvement in 3 (13.6 %) and 4 patients (21.0%), respectively. 2 clinical failures were seen in the ceftriaxone group. One was a severe pelvic infection following vaginal hysterectomy, which responded to the addition of metronidazole, the other was due to a chlamydial salpingitis, which was cured with a 10-day course of doxycycline. Both antibiotics were well tolerated. Our results suggest that for obstetric and gynecologic infections a single 1-gram dose of ceftriaxone is equally effective as three 1-gram doses of cefotaxime.

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Imipenem/cilastatin in the treatment of obstetric and gynecologic infections

Cited by 28 publications

References 19 publications

Microdialysis Study of Imipenem Distribution in Skeletal Muscle and Lung Extracellular Fluids of Noninfected Rats

Microdialysis Study of Imipenem Distribution in Skeletal Muscle and Lung Extracellular Fluids of Noninfected Rats

Pharmacokinetics and transplacental passage of imipenem during pregnancy

Comparison of Ceftriaxone (1 × 1 g/Day) versus Cefotaxime (3 × 1 g/Day) for Gynecologic and Obstetric Infections

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Imipenem/cilastatin in the treatment of obstetric and gynecologic infections

Cited by 28 publications

References 19 publications

Microdialysis Study of Imipenem Distribution in Skeletal Muscle and Lung Extracellular Fluids of Noninfected Rats

Microdialysis Study of Imipenem Distribution in Skeletal Muscle and Lung Extracellular Fluids of Noninfected Rats

Pharmacokinetics and transplacental passage of imipenem during pregnancy

Comparison of Ceftriaxone (1 &times; 1 g/Day) versus Cefotaxime (3 &times; 1 g/Day) for Gynecologic and Obstetric Infections

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Comparison of Ceftriaxone (1 × 1 g/Day) versus Cefotaxime (3 × 1 g/Day) for Gynecologic and Obstetric Infections