Carbapenems in the treatment of severe community-acquired pneumonia in hospitalized elderly patients: A comparative study against standard therapy

Giuseppe Romanelli, P. Cravarezza, A. Pozzi, L. Franchino, G. Ravizzola, R. Zulli, P. Donati, P. Prometti, V. Grassi

Research output: Contribution to journalArticlepeer-review

Abstract

In this open, prospective, study were enrolled 204 hospitalized elderly patients with severe (88 males, 116 females, age range 70-94). Patients were randomized to receive one of the following antibiotic treatment regimens: meropenem 500 mg i.v. t.i.d. (52); imipenem/cilastatin 500 mg i.v. t.i.d. (51), clarithromycin 500 mg + ceftriaxone I g i.v. b.i.d. (52), clarithromycin 500 mg + amikacin 250 mg i.v. b.i.d. (49). In 99 cases causative germs were isolated (24 meropenem, 26 imipenem, 23 clarithromycin + ceftriaxone, 26 ceftriaxone + amikacin). A satisfactory clinical, bacteriological response was achieved respectively in 86.5% 77% in meropenem; 86.3% 71% in imipenem/cilastatin; 69% 61% in ceftriaxone + clarithromycin and in 85.7% 77% in clarithromycin + amikacin. The mean total cost for each patient was $1,560; $1,620; $1,760 and $1,792 in meropenem, imipenem/cilastatin, clarithromycin + ceftriaxone and clarithromycin + amikacin respectively. This study shows that treatment with either meropenem or imipenem is as efficacious as conventional therapy in the treatment of community acquired pneumonia (CAP), and that meropenem is the most cost-effective.

Original languageEnglish
Pages (from-to)609-617
Number of pages9
JournalJournal of Chemotherapy
Volume14
Issue number6
Publication statusPublished - Dec 2002

Keywords

  • Carbapenems
  • Community-acquired pneumonia
  • Elderly

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Microbiology (medical)

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