cilastatin--imipenem-drug-combination and Bone-Diseases

Topics: Adult; Bacteria, Aerobic; Bacteria, Anaerobic; Bacterial Infections; Bone Diseases; Cilastatin; Cilastatin, Imipenem Drug Combination; Drug Combinations; Drug Therapy, Combination; Female; Humans; Imipenem; Male; Middle Aged; Severity of Illness Index; Soft Tissue Infections

Imipenem/cilastatin in a doses of 1.5/day was used to treat 31 moderate to severe infections, predominantly soft tissue infections with bone involvement, in 30 surgical patients. A clinical success was achieved in 93% of the patients. In one patient with diabetic gangrene of the foot, imipenem/cilastatin treatment performed as a last resort was not able to prevent amputation. One patient died from his underlying disease while on therapy. All isolates except one Pseudomonas diminuta strain regarded as contaminant were initially sensitive to imipenem. Two Pseudomonas aeruginosa strains developed resistance by the end of therapy. Staphylococcus aureus and coagulase-negative staphylococci were the most common aetiologic agents. Only few clinical and biochemical side-effects were observed: in two cases an allergic rash appeared following several days' treatment. Four patients developed thrombocytopenia, which, however, was completely reversible after the end of therapy.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Bone Diseases; Cilastatin; Cilastatin, Imipenem Drug Combination; Cyclopropanes; Drug Combinations; Female; Humans; Imipenem; Male; Middle Aged; Postoperative Complications; Prospective Studies; Thienamycins