cilastatin--imipenem-drug-combination and Endometritis

We evaluated the efficacy, patient and medical staff acceptance, and costs of intramuscular therapy with imipenem/cilastatin for mild to moderate upper reproductive tract infection in hospitalized women in an open study. Thirty-five patients were enrolled, and 29 successfully completed the protocol. Of these, 90% were satisfactorily treated with imipenem/cilastatin given intramuscularly. Twenty-eight of 29 subjects tolerated the intramuscular injections well, although 7 women noted mild to moderate discomfort during injection. All patients who had previously received intravenous therapy (24/29) stated that they preferred the intramuscular injections to continuation or reinitiation of intravenous treatment. Therapy with intramuscular imipenem/cilastatin (assuming a marketed price per gram of approximately $30) was associated with cost savings in comparison with other regimens offering similar antibacterial coverage. Initial care provider resistance to treatment with intramuscular imipenem/cilastatin was overcome due to patient satisfaction. Intramuscularly administered imipenem/cilastatin was effective, generally well tolerated, and resulted in cost saving. Intramuscular administration of imipenem/cilastatin may be a preferred antibiotic treatment in patients with mild to moderate infection due to susceptible microorganisms.

Topics: Cesarean Section; Cilastatin; Cilastatin, Imipenem Drug Combination; Consumer Behavior; Costs and Cost Analysis; Drug Administration Schedule; Drug Combinations; Endometritis; Female; Humans; Imipenem; Injections, Intramuscular; Metronidazole; Patient Compliance; Pelvic Inflammatory Disease

Topics: Adult; Anti-Bacterial Agents; Cesarean Section; Cilastatin; Cilastatin, Imipenem Drug Combination; Drug Combinations; Drug Evaluation; Drug Therapy, Combination; Endometritis; Female; Humans; Imipenem; Pregnancy; Puerperal Infection; Surgical Wound Infection