cilastatin--imipenem-drug-combination and Carcinoma--Squamous-Cell

Imipenem/cilastatin sodium (IPM/CS) was administered to 102 patients with respiratory tract infections and lung cancer. Patients with other serious diseases were excluded and a total of 73 patients were enrolled. They were divided into 12 patients who underwent surgery (operated group) and 61 who did not (non-operated group); the latter group included 28 patients treated with anticancer agents or radiation therapy (treated group) and 33 untreated patients (untreated group). IPM/CS was effective in 75% of the patients, both with and without surgery. The drug was effective in 81% of the treated group, although many of the patients had Stage III or more advanced cancer, as well as bronchial occlusion. IPM/CS was also effective in 69% of the untreated group, although many of the patients have serious infections and a PS (Performance Status) of 3 or greater. Thus, IPM/CS treatment achieved good results. Bacteriological studies showed that 3 out of 4 strains in the operated group and 16 out of 18 in the non-operated group were eliminated. Safety was evaluated in all patients. Two patients (2%) experienced side effects and two others (2%) showed abnormal clinical findings, but the symptoms were mild and resolved after discontinuation or completion of therapy. In conclusion, IPM/CS was very effective for treating respiratory infections in patients with lung cancer.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Carcinoma, Large Cell; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Cilastatin; Cilastatin, Imipenem Drug Combination; Drug Combinations; Drug Therapy, Combination; Female; Humans; Imipenem; Infusions, Intravenous; Lung Neoplasms; Male; Middle Aged; Neoplasm Staging; Opportunistic Infections; Respiratory Tract Infections

A 78-year-old man underwent a left lower sleeve lobectomy and lymph node dissection for lung cancer. His postoperative course had been uneventful until postoperative day (POD) 3, but severe dyspnea occurred suddenly and the chest X-p showed infiltration shadow on POD 3. Streptococcus pneumonia antigen in the urine was elevated, suggesting pneumonia caused by Streptococcus pneumonia. The patient was treated with double dose of imipenem/cilastatin sodium and supported with a mechanical ventilator in an intensive care unit. Although the patient recovered from penicillin resistant Streptococcus pneumonia, he was suffered from Klebsiella sepsis and expired on the POD 26.

Topics: Aged; Carcinoma, Squamous Cell; Cilastatin; Cilastatin, Imipenem Drug Combination; Drug Combinations; Fatal Outcome; Humans; Imipenem; Klebsiella Infections; Lung Neoplasms; Male; Penicillin Resistance; Pneumonia, Pneumococcal; Postoperative Complications; Sepsis; Streptococcus pneumoniae; Ventilators, Mechanical

Topics: Adenocarcinoma; Adult; Aged; Anti-Bacterial Agents; Carcinoma, Non-Small-Cell Lung; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Cilastatin; Cilastatin, Imipenem Drug Combination; Drug Combinations; Humans; Imipenem; Injections, Intravenous; Lung Neoplasms; Male; Middle Aged; Pneumonectomy; Postoperative Care; Postoperative Complications; Time Factors