Safety of Imipenem in Neonates

Stuart, Rhonda L.; Jd, Turnidge; Grayson, M. L.

doi:10.1097/00006454-199509000-00014

Cited by 16 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11 Its use in neonates with serious infections has been documented, 12 and it appears to be associated with a lower incidence of seizures in the preterm and severely ill neonate in the intensive care setting. 13 However, the rapid development of imipenem resistance with widespread use of imipenem/cilastatin is a source of concern, and safe, effective alternatives need to be explored to preserve its efficacy in the treatment of nosocomial multidrug-resistant bacterial infections.…”

Section: Discussionmentioning

confidence: 99%

Piperacillin/Tazobactam in the Treatment ofKlebsiella PneumoniaeInfections in Neonates

Pillay

Adhikari

et al. 1998

Amer J Perinatol

View full text Add to dashboard Cite

Nosocomial Klebsiella pneumoniae infection is associated with a high mortality in neonates and antimicrobial therapy of these infections has been complicated by the emergence of multiresistant strains. These organisms remain susceptible to only a few antimicrobial agents, and some of these are not recommended for use in children. In this study the antimicrobial agents used in the treatment of 33 neonates with Klebsiella pneumoniae (K. pneumonia) infection in our tertiary neonatal unit, during an outbreak were: piperacillin/tazobactam (13), imipenem/cilastatin (17), cefotaxime (2), and ciprofloxacin (1). Extended-spectrum beta-lactamase production was detected in K. pneumoniae isolates from 18 of 33 (54.5%) neonates. All-cause mortality was 13 of 33 (39.4%) and there was no significant difference in mortality between neonates treated with imipenem/cilastatin (6 of 17 or 35.3%) and neonates treated with piperacillin/tazobactam (6 of 13 or 46.2%). The duration of antimicrobial therapy and total hospital stay was similar between neonates who received imipenem/cilastatin and those that received piperacillin/tazobactam. This report suggests that piperacillin/tazobactam may be a useful antimicrobial agent in neonatal infections caused by beta-lactamase-producing organisms.

show abstract

Section: Discussionmentioning

confidence: 99%

Piperacillin/Tazobactam in the Treatment ofKlebsiella PneumoniaeInfections in Neonates

Pillay

Adhikari

et al. 1998

Amer J Perinatol

View full text Add to dashboard Cite

show abstract

“…A seizure incidence of 2.5% was reported in a series of 80 infants 24–41-weeks gestational age treated with imipenem/cilastatin during an outbreak of multidrug resistant Klebsiella pneumoniae from 1994–1995 in a single NICU. 10 In this study, the mean daily dose of imipenem/cilastatin was 25 mg/kg, though 1 infant suffered a seizure at a dose of only 20 mg/kg/day. Another single-center study of 104 infants 25–41-weeks gestational age treated with imipenem/cilastatin reported a seizure incidence of 8.9%.…”

Section: Discussionmentioning

confidence: 72%

“…3,4 Safety data for these 2 antibiotics in hospitalized infants are limited to single-center studies that have reported variable incidences of seizures. 10–14 No randomized studies comparing the safety of imipenem/cilastatin against meropenem have been conducted in any pediatric patient populations. We sought to compare the safety profile of imipenem/cilastatin versus meropenem in neonates and young infants using a large multicenter database.…”

mentioning

confidence: 99%

Adverse Events Associated With Meropenem Versus Imipenem/Cilastatin Therapy in a Large Retrospective Cohort of Hospitalized Infants

Hornik¹,

Herring

Benjamin³

et al. 2013

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

Background Carbapenems are commonly used in hospitalized infants despite a lack of complete safety data and associations with seizures in older children. We compared the incidence of adverse events in hospitalized infants receiving meropenem versus imipenem/cilastatin. Methods We conducted a retrospective cohort study of 5566 infants treated with meropenem or imipenem/cilastatin in neonatal intensive care units managed by the Pediatrix Medical Group between 1997 and 2010. Multivariable conditional logistic regression was performed to evaluate the association between carbapenem therapy and adverse events, controlling for infant factors and severity of illness. Results Adverse events were more common with use of meropenem compared with imipenem/cilastatin (62.8/1000 infant days vs. 40.7/1000 infant days, P<0.001). There was no difference in seizures with meropenem vs. imipenem/cilastatin (adjusted odds ratio [OR] 0.96; 95% confidence interval 0.68, 1.32). The incidence of death, as well as the combined outcome of death or seizure, was lower with meropenem use—OR 0.68 (0.50, 0.88) and OR 0.77 (0.62, 0.95), respectively. Conclusion In this cohort of infants, meropenem was associated with more frequent but less severe adverse events when compared with imipenem/cilastatin.

show abstract

“…Several newer antibiotics are finding a place in difficult cases. Aztreonam 34 and imipenem 35 are valuable in the treatment of gramnegative sepsis. When necrotising enterocolitis is suspected, it is usual to add metronidazole to cover anaerobes.…”

Section: Early Diagnosis Of Sepsis -Use Of Adjunctive Testsmentioning

confidence: 99%