[Clinical investigation on target value of T>MIC in carbapenems]

Jpn J Antibiot. 2008 Apr;61(2):73-81.
[Article in Japanese]

Abstract

There have been few clinical reports on pharmacokinetics-pharmacodynamics (PK-PD) theory, although many basic or fundamental researches on appropriate use for the antimicrobials based on the PK-PD theory have been performed. We evaluated the target T>MIC values on meropenem and biapenem which have been obtained by basic researches. While we investigated whether the target T>MIC values were also useful for anaerobic infections. Clinical and bacteriological efficacies of meropenem and biapenem were about 70% in T>MIC over 25% or over 80% in T>MIC over 30%. When monomicrobial infections by anaerobes were occurred as abscesses, there have been no correlation between target T>MIC values and clinical effect. When polymicrobial infections between aerobes and anaerobes were occurred, we have achieved over 90% clinical efficacy when over 20% T>MIC values. These results supported the data by Craig, W. A. and Drusano, G. L. The regimen based on PK-PD theory would be useful in clinical practice including against anaerobic infections.

MeSH terms

  • Adult
  • Bacteria, Aerobic / drug effects*
  • Bacteria, Anaerobic / drug effects*
  • Bacterial Infections / drug therapy*
  • Carbapenems / administration & dosage*
  • Carbapenems / pharmacokinetics
  • Carbapenems / pharmacology*
  • Drug Administration Schedule
  • Drug Resistance, Microbial
  • Escherichia coli / drug effects
  • Escherichia coli / isolation & purification
  • Female
  • Humans
  • Meropenem
  • Middle Aged
  • Pelvic Inflammatory Disease / microbiology*
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / isolation & purification
  • Thienamycins / administration & dosage*
  • Thienamycins / pharmacokinetics
  • Thienamycins / pharmacology*

Substances

  • Carbapenems
  • Thienamycins
  • Meropenem
  • biapenem