The pharmacokinetics of meropenem (ICI 194,660) and its open-ring metabolite (ICI 213,689) were studied in 6 healthy volunteers and 16 patients with moderate to severe renal impairment after a single intravenous dose of 500 mg given as a 30-min infusion. Concentrations of unchanged meropenem in plasma and urine were measured by both microbiological and high-pressure liquid chromatographic (HPLC) assays. A good correlation was found between the two techniques. Pharmacokinetic parameters of unchanged meropenem were determined by using the HPLC data. The terminal half-lfe of unchanged meropenem increased in relation to the degree of renal impairment, being 1.2 h in subjects with normal renal function and 10 h in patients with end-stage renal failure. Total body clearance and renal clearance of unchanged meropenem are lnearly related to creatinine clearance. The concentrations of the metabolite in plasma, which are very low in healthy subjects, signcantl increased in uremic patients. The apparent half-life of ICI 213,689 increased in uremic patients and was about 35 h in patients with severe renal insufficiency. Meropenem and its metabolite are effectively removed by hemodialysis. The dialysis clearance of the unchanged drug was 81 J 22 ml/min. Dosage adjustments of meropenem will be necessary in patients with severe renal impairment.Meropenem (ICI 194,660) is a new parenteral carbapenem antibiotic characterized by a broad antibacterial spectrum. It has been shown to have activity against both gram-positive and gram-negative pathogens, including anaerobes such as Bacteroidesfragilis. Meropenem is more active in vitro than imipenem against members of the family Enterobacteriaceae and Pseudomonas aeruginosa. Unlike imipenem, meropenem shows a good stability against human renal dehydropeptidase I and does not require the coadministration of a dehydropeptidase I enzyme inhibitor such as cilastatin (4,7,(9)(10)(11).The purpose of this study was to investigate the pharmacokinetics of meropenem (ICI 194,660) and of its open-ring metabolite (ICI 213,689) in patients with moderate or severe renal impairment after a single intravenous (i.v.) dose of 500 mg given as a 30-min infusion.

Our results show the feasibility of this dried serum spot method for monitoring resistance to antiretroviral drugs and the molecular epidemiology of HIV diversity. The simplicity of sample preparation, storage and transport potentially makes this an importance tool for individual and epidemiological monitoring throughout the world.

A case of metronidazole- and albendazole-resistant giardiasis in a patient with the acquired immunodeficiency syndrome was successfully treated with nitazoxanide (1.5 g twice a day for 30 days). Animal studies and in vitro assays showed that the isolate was resistant to both metronidazole and albendazole and susceptible to nitazoxanide.

Intravenous ZDV remains an effective tool to reduce transmission in cases of virological failure, even in cART-treated women. However, for the vast majority of women with low viral loads at delivery, in the absence of obstetrical risk factors, systematic intravenous ZDV appears to be unnecessary.