Basic and clinical studies of biapenem in the surgical field

Abstract

Basic and clinical studies of biapenem (BIPM), a new carbapenem antibiotic, were performed in the field of gastroenterological surgery and the results were as follows:
1. Antibiotic activity: BIPM exhibited excellent antibiotic activity against clinically isolated MSSA, Staphylococcus aureus against which the MICs of methicillin were less than 6.25μg/ml, while the MICs of the drug were high against clinically isolated MRSA. S. aureus against which the MICs of methicillin were not less than 12.5μg/ml. The drug also showed excellent activity against Enterococcus sp. by its MIC₉₀ of 6.25μg/ml and against gram-negative bacilli including Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Proteus mirabilis, Enterobacter cloacae, Enterobacter aerogenes, Citrobacter freundii, Acinetobacter calcoaceticus by its MIC₉₀ being less than 3.13μg/ml. The antibiotic demonstrated good activity against Serratia marcescens, Pseudomonas aeruginosa and Pseudomonas cepacia except for a part the strains, against which its MICs were high.
2. Pharmacokinetics: Intravenous drip infusion of BIPM (300mg) were administered to patients undergoing cholecystectomy (2), colectomy (1), total gastrectomy (1) and distal pancreatectomy (1), and the distributions of the drug in the plasma, ascites, peritoneum, pancreas, gallbladder wall and urine were measured. The distribution in the ascites was almost same as that in the plasma. The concentration in the peritoneum was 1.3μg/ml at 1hr after completion of the infusion.
3. Clinical effects: BIPM was administered to 25 patients with postoperative wound infection (7), perforative peritonitis (5), intraabdominal abscess (5), subphrenic abscess (2), intraabdominal abscess concurring with wound infection (1), retroperitoneal abscess (1), local peritonitis (1), cholangitis (1), cholecystitis (1) and catheter sepsis (1) as infection in the field of gastroenterological surgery. The results were excellent in 3 cases, good in 18 cases and fair in 4 cases. Eruption was observed in one case as side effect, and abnormal laboratory finding was noted in another case.
From the above results, BIPM was considered to be a useful antibiotic against surgical infections.