Studies on meropenem for treatment of tonsillitis and enfectious disease in the upper aerodigestive tracts region

Abstract

Safety and efficacy of meropenem (MEPM) for treatment of lacunar tonsillitis, peritonsillitis, peritonsillar abscess, and other infectious diseases of the upper aerodigestive tract were evaluated clinically, pharmacokinetically and bacrteriologically. At a concentrations of≤1.13μg/ml, MEPM completely inhibited growth of 56 strains of gram-positive bacteria isolated from the patients with tonsillitis. The inhibitory effect of MEPM on gram-negative bacteria was superior to imipenem, ceftazidime, cefoperazone, flomoxef, piperacillin and cefotiam. MEPM concentrations after intravenous administration at a dose of 0.5g were 0.35 to 2.85ug/g in the tonsillar tissues at 30 to 115 minutes, and 0.55 to 3.8μg/g in the submandibular salivary gland tissues at 30 to 140 minutes. Clinical efficacy of MEPM was evaluated in 86 patients. The physician-assessed efficacy rate, including both excellent and good responses, was rated at 96.6% (83/86), while that of the Efficacy Assessment Committee was 93.0% (80/86). All bacterial pathogens were eradicated except three strains isolated in patients with buccal phlegmon and lacunar tonsillitis. No side effects were observed in 91 cases evaluated, although serum transaminase was elevated in five cases, and eosinophila and neutropenia were each observed in one case. The results of these studies indicate that MEPM is highly effective in the treatment of patients with acute tonsillitis and upper aerodigestive tract infections.