Efficacy of doripenem against Escherichia coli and Klebsiella pneumoniae in experimental meningitis

J Antimicrob Chemother. 2012 Mar;67(3):661-5. doi: 10.1093/jac/dkr482. Epub 2011 Dec 16.

Abstract

Objectives: In this study the efficacy of doripenem, a new broad-spectrum carbapenem, was tested against an Escherichia coli strain and a Klebsiella pneumoniae strain in an experimental animal model. The comparator was cefepime monotherapy.

Methods: The rabbit meningitis model was used in this study and the penetration of doripenem through uninflamed and inflamed meninges was determined.

Results: Doripenem, injected three times (75 mg/kg), led to serum peak levels around 100 mg/L and trough levels around 5 mg/L, resulting in a penetration rate of 14% through inflamed meninges and 7% through uninflamed meninges. Against K. pneumoniae, doripenem was slightly but not significantly more efficacious than cefepime over 8 h (5.40 ± 1.37 log(10) cfu/mL versus 3.59 ± 0.89 log(10) cfu/mL for cefepime). Also against the E. coli strain doripenem was slightly superior to the comparator (5.55 ± 0.87 log(10) cfu/mL versus 3.80 ± 1.10 log(10) cfu/mL for cefepime), although the difference was not significant.

Conclusions: Doripenem is a potential monotherapy for the treatment of meningitis due to Gram-negative microorganisms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Bacterial Agents / administration & dosage*
  • Bacterial Load
  • Carbapenems / administration & dosage*
  • Cefepime
  • Cephalosporins / administration & dosage
  • Disease Models, Animal
  • Doripenem
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / drug therapy*
  • Klebsiella Infections / drug therapy*
  • Klebsiella pneumoniae / isolation & purification
  • Meningitis, Bacterial / drug therapy*
  • Rabbits
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Cephalosporins
  • Cefepime
  • Doripenem