Antimicrobial activity and clinical evaluation of biapenem in urinary tract infections

Abstract

The in vitro antimicrobial activity and clinical efficacy of biapenem (BIPM), a new carbapenem, were investigated. The antimicrobial activities of BIPM to 330 strains each of methicillin-resistantStaphylococcus aureus (MRSA), Enterococcus faecalis, Escherichia coli, Citrobacter freundii, Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens, Proteus mirabilis, Proteus vulgaris andPseudomonas aeruginosa isolated from the patients with urinary tract infections (UTI) was measured by the agar dilution method. Inoculum size was 10⁶ CFU/ml and the results were compared with those of imipenem (IPM), flomoxef (FMOX), ceftazidime (CAZ) and ofloxacin (OFLX). Antimicrobial activities of BIPM against both gram-positive and gram-negative bacteria were similar to those of IPM, and superior to those of FMOX, CAZ and OFLX.
BIPM was given to 22 patients with 21 of complicated UTIs and one of acute bacterial prostatitis at a dose of 300 or 600mg per day for 5-6 days. The overall clinical efficacy of 20 complicated UTI patients evaluated by doctors was 80%, and that of 18 patients with complicated UTI patients according to the criteria proposed by the Japanese UTI committee was 77.8%. Evaluation of a case acute bacterial prostatitis was excellent by both evaluation method. Twenty seven of 28 strains (96.4%) isolated from patients with UTIs or prostatitis including 10 gram-positive cocci and 2 P. aeruginosa strains. As abnormal laboratory data after administration of BIPM, slight elevation of GOT and GPT in one patient was noted. Adverse reaction was not observed.