OBJECTIVETo evaluate the efficacy and safety of meropenem in Chinese patients, we conducted a study for the treatment of patients with lower respiratory tract infections, urinary tract infections and other infections.

METHODSA total of 182 hospitalized patients were enrolled in the study. 90 patients received 500 mg meropenem every 12 hours (or 1 g every 12 hours if necessary) and 92 patients received imipenem/cilastatin 500 mg/500 mg every 12 hours (or 1 g every 12 hours if necessary) by intravenous infusion. The duration of treatment was 7 - 14 days for both groups.

RESULTSSeventy of 90 cases receiving meropenem and 70 of 92 cases receiving imipenem/cilastatin were assessable for clinical efficacy. The overall efficacy rates were 90% for the meropenem group and 87% for the imipenem/cilastatin group, and the bacterial eradication rates were 86% in both groups. 93 (76%) of 123 strains isolated from patients produced beta-lactamases. Adverse drug reactions were evaluated in 72 cases in the meropenem group and 70 cases in the imipenem/cilastatin group. The adverse drug reaction rates were 9.7% and 8.6%, respectively. The results showed that there were no statistical differences between these two groups (P > 0.05).

CONCLUSIONMeropenem is effective and safe for the treatment of bacterial infections caused mainly by beta-lactamase-producing strains.

Adult ; Aged ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Cilastatin ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Humans ; Imipenem ; administration & dosage ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Respiratory Tract Infections ; drug therapy ; Thienamycins ; adverse effects ; therapeutic use ; Urinary Tract Infections ; drug therapy

Objective To evaluate the role of H1 receptor in inflammatory responses during ventila-tor-induced lung injury ( VILI) in rats. Methods Thirty clean-grade healthy male Sprague-Dawley rats, aged 9-10 weeks, weighing 250-300 g, were divided into 3 groups ( n=10 each) using a random number table method: control group (group C), VILI group (group V) and H1 receptor antagonist clemastine group ( group Cle) . The animals were anesthetized and tracheostomized, and the rats in group C kept spon-taneous breathing. The rats were mechanically ventilated for 4 h with the tidal volume of 40 ml/kg, respira-tory rate 40 breaths/min, inspiratory/expiratory ratio 1 : 1, and inspired oxygen fraction ratio 21％ in group V. In group Cle, clemastine 0. 9 mg/kg was intramuscularly injected at 30 min before anesthesia, the ani-mals were tracheostomized after being anesthetized, and then the rats were mechanically ventilated with the same ventilator settings as group V. The animals were sacrificed at 4 h of ventilation, bronchoalveolar lav-age fluid ( BALF) was collected for determination of concentrations of total protein, interleukin-6 ( IL-6) , tumor necrosis factor-alpha ( TNF-α) , and the lung specimens were obtained for microscopic examination of pathologic changes and for determination of wet/dry weight ratio ( W/D ratio ) . Results Compared with group C, the concentrations of total protein, IL-6 and TNF-αin BALF and W/D ratio were significantly in-creased in group V (P＜0. 05). Compared with group V, the concentrations of total protein, IL-6 and TNF-αin BALF and W/D ratio were significantly decreased in group Cle ( P＜0. 05) . The pathologic chan-ges of lung tissues were significantly attenuated in group Cle as compared with group V. Conclusion H1 receptor is involved in the process of inflammatory responses during VILI in rats.