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Therapeutic Methods and Therapies TCIM
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1.
Pharmacotherapy ; 37(10): e96-e102, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28699652

ABSTRACT

Infections caused by carbapenemase-producing Enterobacteriaceae (CPE) are becoming increasingly common worldwide. Although CPE infections can be fatal, few reports in the literature have described effective and successful treatments for infectious diseases caused by several types of IMP CPE, and, to our knowledge, no reports have described the successful treatment of IMP-6 CPE infections. We describe two patients who developed bacteremia caused by IMP-6 CPE after surgery for cancer who were successfully treated with amikacin plus high-dose prolonged-infusion meropenem. Both patients were treated over a 2-week period using amikacin 15 mg/kg at various intervals based on therapeutic drug monitoring and meropenem 2000 mg infused over 3 hours every 12 hours. The dosages of amikacin and meropenem were determined based on the creatinine clearance of each patient. Both patients were cured of their bacteremia and did not experience any antibiotic-related adverse effects. Based on the outcomes of these patients, it appears that amikacin plus high-dose prolonged-infusion meropenem may be safe and effective for the treatment of bacteremia caused by IMP-6 CPE.


Subject(s)
Amikacin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Carbapenem-Resistant Enterobacteriaceae/enzymology , Enterobacteriaceae Infections/drug therapy , Thienamycins/therapeutic use , Aged , Amikacin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Bacteremia/microbiology , Bacterial Proteins/biosynthesis , Carbapenem-Resistant Enterobacteriaceae/drug effects , Drug Therapy, Combination , Enterobacteriaceae Infections/microbiology , Humans , Male , Meropenem , Microbial Sensitivity Tests , Thienamycins/administration & dosage , Treatment Outcome , beta-Lactamases/biosynthesis
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