Vol.61 No.6 November 2013
Changes in blood concentration and usefulness of 24-hour continuous infusion of biapenem for treating respiratory tract infection
1)Internal Medicine, Tomioka Public General Hospital, 2073-1 Tomioka, Tomioka, Gunma, Japan
2)Infection Control and Prevention Center, Gunma University Hospital
3)Gunma University Graduate School of Health Sciences
Abstract
This study examined whether sufficient blood concentration was achieved through blood concentration measurements after a 24-hour continuous infusion of biapenem(BIPM) for respiratory tract infection. Currently, there is little information on clinical blood concentration measurements after 24-hour continuous infusion of BIPM, and it is not known if sufficient blood concentration is achieved or not. Carbapenem serves as an index for enhancing drug characteristics based on how much t >MIC can be achieved. Therefore, we inspected the 24-hour continuous infusion of BIPM in a clinical setting to obtain sufficient t >MIC, despite the deviation in dosage and administration. We examined patients aged between 20 and 90 years admitted to the Department of Internal Medicine at Tomioka General Hospital who had been diagnosed as having moderate or severe respiratory tract infection. Patients in the low-dose group received an infusion of BIPM at an initial dose of 0.3 g for 1 hour, followed by a continuous infusion of 0.6 g for 24 hours. From the second day onward, patients received a 24-hour continuous infusion of 0.6 g. Patients in the high-dose group received an infusion of BIPM at an initial dose of 0.6 g for 1 hour, followed by a continuous infusion of 1.2 g for 24 hours. Seven men and five women were included in this study, of whom 2 had moderate respiratory tract infection and 10 had severe respiratory tract infection. There was one case each of the underlying diseases of cerebral infarction sequelae, diabetes mellitus, lung cancer, cardiac failure, and chronic respiratory failure, 3 cases each of chronic obstructive pulmonary disease and bronchiectasis, and 2 patients with no underlying diseases. BIPM was effective in 2 of 2 patients with moderate respiratory tract infection and 8 of 10 patients with severe respiratory tract infection. One patient had side effects of increased AST, ALT, and ALP, but these reactions were mild and did not require the treatment to be discontinued. Plasma BIPM concentration from 12 hours after the start of BIPM infusion ranged from 0.8-1.8 μg/mL in the low-dose group and 2.2-6.9 μg/mL in the high-dose group.
Key word
biapenem, pneumonia, efficacy, safety, continuous infusion
Received
March 21, 2013
Accepted
September 9, 2013
Jpn. J. Chemother. 61 (6): 510-513, 2013
