A comparative study of meropenem and ceftazidime in the treatment of patients hospitalized with community-acquired pneumonia

Berman, Steven; Sieger, Barry; Geckler, Ronald W.; Farkas, Stephen A.

doi:10.1016/s0011-393x(97)80058-6

Cited by 9 publications

(4 citation statements)

References 22 publications

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“…In most trials, the primary efficacy endpoint was trials in adult and paediatric patients. Most clinical or bacteriological response at end of treatwere open-label trials; [63][64][65][66][67][68][69][70][71][72][73][74][75][76]78,[80][81][82][83][84][85][86][87][88][89][90][93][94][95][96][98][99][100][101][102][103][104][105][106] four ment (EOT) and/or the follow-up visit. Although were of double-blind design [79,92,[107][108][109] (one [103] also definitions varied between trials, clinical response included a placebo arm) and four [77,91,96,110] were of was usually defined as disappearance or improvesingle-blind design.…”

Section: Potential Drug Interactionsmentioning

confidence: 99%

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Meropenem

Baldwin

Lyseng‐Williamson

Keam

2008

Drugs

179

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Meropenem (Merrem, Meronem) is a broad-spectrum antibacterial agent of the carbapenem family, indicated as empirical therapy prior to the identification of causative organisms, or for disease caused by single or multiple susceptible bacteria in both adults and children with a broad range of serious infections. Meropenem is approved for use in complicated intra-abdominal infection (cIAI), complicated skin and skin structure infection (cSSSI) and bacterial meningitis (in paediatric patients aged > or = 3 months) in the US, and in most other countries for nosocomial pneumonia, cIAI, septicaemia, febrile neutropenia, cSSSI, bacterial meningitis, complicated urinary tract infection (UTI), obstetric and gynaecological infections, in cystic fibrosis patients with pulmonary exacerbations, and for the treatment of severe community-acquired pneumonia (CAP). Meropenem has a broad spectrum of in vitro activity against Gram-positive and Gram-negative pathogens, including extended-spectrum beta-lactamase (ESBL)- and AmpC-producing Enterobacteriaceae. It has similar efficacy to comparator antibacterial agents, including: imipenem/cilastatin in cIAI, cSSSI, febrile neutropenia, complicated UTI, obstetric or gynaecological infections and severe CAP; clindamycin plus tobramycin or gentamicin in cIAI or obstetric/gynaecological infections; cefotaxime plus metronidazole in cIAI; cefepime and ceftazidime plus amikacin in septicaemia or febrile neutropenia; and ceftazidime, clarithromycin plus ceftriaxone or amikacin in severe CAP. Meropenem has also shown similar efficacy to cefotaxime in paediatric and adult patients with bacterial meningitis, and to ceftazidime when both agents were administered with or without tobramycin in patients with cystic fibrosis experiencing acute pulmonary exacerbations. Meropenem showed greater efficacy than ceftazidime or piperacillin/tazobactam in febrile neutropenia, and greater efficacy than ceftazidime plus amikacin or tobramycin in patients with nosocomial pneumonia. Meropenem is well tolerated and has the advantage of being suitable for administration as an intravenous bolus or infusion. Its low propensity for inducing seizures means that it is suitable for treating bacterial meningitis and is the only carbapenem approved in this indication. Thus, meropenem continues to be an important option for the empirical treatment of serious bacterial infections in hospitalized patients.

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Section: Potential Drug Interactionsmentioning

confidence: 99%

“…[120] Comparators includwith corresponding satisfactory bacteriological resed imipenem/cilastatin, [99,100] ceftazidime [120] and ponse rates of 89% and 87%. [101] combinations of clarithromycin with amikacin or Table XIII. Efficacy of meropenem (MEM) in patients (pts) with community-acquired pneumonia.…”

Section: In Hospitalized Women With Gynaecological Ormentioning

confidence: 99%

Meropenem

Baldwin

Lyseng‐Williamson

Keam

2008

Drugs

179

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“…Meropenem, which exhibits potent broad‐spectrum bactericidal activity, β‐lactamase stability and good tissue penetration, was evaluated in an extensive clinical trial programme. When used as monotherapy, meropenem produced consistent efficacy similar to that of standard treatment regimens, including imipenem/cilastatin and combinations, in the treatment of a variety of serious infections in adults and children [22–37; AstraZeneca, data on file].…”

Section: Discussionmentioning

confidence: 99%

“…Taken together, these findings support the view that other ‘patient’ factors might have been implicated in treatment failure, and closer inspection of the individual studies upon which the present analysis was derived may be useful. The studies by Sieger et al [26] and Berman et al [24], in hospital‐ and community‐acquired lower respiratory tract infections, respectively, showed good pathogen eradication rates with meropenem against P. aeruginosa , with 80–100% of pathogens being eradicated. However, lower eradication rates against this pathogen were observed by Mouton et al [22] and Colardyn et al [25].…”

Section: Discussionmentioning

confidence: 99%

Meropenem: clinical response in relation to in vitro susceptibility

Drusano

Lode

Edwards

2000

Clinical Microbiology and Infection

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The attractive in vitro profile of meropenem translates into good clinical efficacy. The National Committee for Clinical Laboratory Standards has now defined meropenem MIC breakpoints for nonfastidious aerobes or anaerobes as < or = 4 (susceptible), 8 (intermediate) and > or = 16 mg/L (resistant), respectively. The susceptibility breakpoint for Streptococcus spp. (excluding Streptococcus pneumoniae) is < or = 0.5 mg/L and, since meropenem is indicated for the treatment of meningitis, the susceptibility breakpoint for S. pneumoniae and Haemophilus influenzae is < or = 0.25 and < or = 0.5 mg/L, respectively. Meropenem monotherapy is therefore a valid option for the initial empirical treatment of a range of serious infections caused by single or multiple bacterial pathogens.

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