Abstract
Twenty three neonates and young infants were treated with imipenem/cilastatin sodium (IPM/CS) and its clinical efficacy and side effects were evaluated. Ages of the patients ranged from 0 to 83 days, and their body weights ranged from 750 to 4,760g. Doses of IPM/CS ranged from 17.4 to 21.5mg/kg as IPM every 6 to 12 hours for 3 to 12 days. Sixteen patients with infections including sepsis, meningitis and pneumonia, appeared to have responded to the IPM/CS treatment. Among them, clinical results were excellent in 2, good in 12 and fair in 2 patients. The drug was well tolerated, but 1 patient had diarrhea, 1 had redness of body during infusion, 1 had elevated GOT and GPT, and 2 patients showed only elevated values of GOT only among the 23 patients.
The pharmacokinetics of IPM/CS were studied in 7 patients. Their ages ranged from 0 to 9 days, and body weights ranged from 2.5 to 4.0kg. Serum concentrations of IPM were between 18.0 and 96.9μg/ml and those of CS ranged 31.7 and 144.5μg/ml in 6 patients at the end of intravenous drip infusion 20mg/20mg/kg during 30 or 60 minutes. Elimination half-lives of IPM ranged from 1.2 to 2.0 hours, and those of CS ranged from 1.4 to 2.7 hours. Serum concentrations of IPM was 14.7μg/ml and that of CS was 32.4μg/ml in 1 patient at the end of 30 minute-drip infusion 10mg/10mg/kg. Theelimination half-lives of IPM was 1.5 hours, and that of CS was 2.9 hours. The urinary recovery of IPM/CS in 6 hours during and after drip infusion in 5 patients,IPM ranged from 12.5 to 26.3% and CS ranged from 14.9 to 57.6%.
In 1 patient with bacterial meningitis given 20mg/kg of the drug every 6 hours, the cerebrospinal fluid/serum concentration ratio of IPM at 2.75 hours after a dose on the third day of treatment was 23.8%, and that at 3.5 hours after a dose on theseventh day was 19.1%.
