Imipenem and Meropenem: Comparison of In Vitro Activity, Pharmacokinetics, Clinical Trials and Adverse Effects
Loading...
Date
1998-1-1
Authors
Zhanel, George G
Simor, Andrew E
Vercaigne, Lavern
Mandell, Lionell
the Canadian Carbapenem Discussion Group,
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
OBJECTIVE: To compare and contrast imipenem and meropenem in terms of in vitro activity, pharmacokinetics, clinical efficacy and adverse effects.DATA SELECTION: MEDLINE search from 1975 to 1997 and follow-up of references.DATA EXTRACTION: Clinical trials comparing imipenem with meropenem, or either imipenem or meropenem with standard therapy in the treatment of serious infections were selected.DATA SYNTHESIS: Imipenem, the first carbapenem, was first marketed in 1987; meropenem was introduced to the market in 1996. In general, imipenem is more active against Gram-positive cocci while meropenem is more active against Gram-negative bacilli. The agents display similar pharmacokinetics. Clinical studies in patients with serious infections (intra-abdominal infection, respiratory infection, septicemia, febrile neutropenia) report similar bacteriological and clinical cure rates with imipenem and meropenem. Meropenem is approved for the treatment of bacterial meningitis, whereas imipenem is not. Adverse effects are similar.CONCLUSIONS: Current literature supports the use of imipenem at a dose of 500 mg every 6 h and meropenem at 1 g every 8 h for the treatment of severe infections. For the treatment of serious infections, imipenem (500 mg every 6 h or 2 g/day [$98/day]) is more economical than meropenem (1 g every 8 h or 3 g/day [$142/day]) based on acquisition cost.
Description
Keywords
Citation
George G Zhanel, Andrew E Simor, Lavern Vercaigne, Lionell Mandell, and the Canadian Carbapenem Discussion Group, “Imipenem and Meropenem: Comparison of In Vitro Activity, Pharmacokinetics, Clinical Trials and Adverse Effects,” Canadian Journal of Infectious Diseases, vol. 9, no. 4, pp. 215-228, 1998. doi:10.1155/1998/831425