M005 MEROPENEM IS EFFICIENT FOR TREATMENT OF CHRONIC
LUNG INFECTION WITH RESISTANT P. AERUGINOSA AND B.CEPACIA
IN CYSTIC FIBROSIS (CF) PATIENTS.
O.Ciofu, T.Jensen, T.Pressler, N.Høiby and C.Koch, Danish
CF Centre, Copenhagen, Denmark
Meropenem has been administrated to 55 CF patients (age: 25,5+1 yrs); 50 chronically infected with multi-resistant P.aeruginosa(P.A) and 5 with Burkholderia cepacia, in a total of 107 i.v courses (1-6 courses/ patient). 50 courses were monotherapy, 30 in combination with tobramycin, 9 with ciprofloxacin, and in 5 courses( for B.cepacia) inhalation with ceftazidime was also administrated. Dose of meropenem: 2g t.i.d, iv. bolus, for 14 days.
Mean pulmonary function increased during therapy for P.A (FEV1: +17%, FVC: +18%) and during therapy for B.cepacia (FEV1:+28%, FVC: +27%).C reactive protein decreased significantly (p=0.0005 and p=0.04, respectively).
The geometric mean of MIC (g/ml) for P.A (B.cepacia) were: Tobramycin: 6 (59), ciprofloxacin: 1.2 (9.7), piperacillin: 49 (16.3), ceftazidime: 26 (23), aztreonam: 26 (35), imipenem: 34 (54) and meropenem: 5.1 (4.8). No statistically significant increase in the MIC of meropenem occurred after therapy
In 27 of the 107 courses a mild and transient increase in transaminases was observed, otherwise no biochemical changes occurred during the treatment.
95 of the 107 courses were tolerated without any clinical complains. The following side-effects were observed: nausea(0.9%), itching (5%), rash(3%) which led to the cessation of the treatment in 2% of the courses.
In conclusion meropenem proved to be a valuable drug in the treatment of chronic pulmonary infection with multi-resistant P.aeruginosa and B.cepacia.