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Int J Antimicrob Agents ; 43(4): 353-60, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24636429

ABSTRACT

Doripenem is approved in the Asia-Pacific (APAC) region for treating nosocomial pneumonia (NP) including ventilator-associated pneumonia (VAP), complicated intra-abdominal infections (cIAIs) and complicated urinary tract infections (cUTIs). Clinical usage of doripenem (500mg intravenously, infused over 1h or 4h every 8h for 5-14 days) in APAC was evaluated in a prospective, open-label, non-comparative, multicentre study of inpatients (≥18 years) with NP, VAP, cIAI or cUTI. A total of 216 [intention-to-treat (ITT)] patients received doripenem: 53 NP (24.5%); 77 VAP (35.6%); 67 cIAI (31.0%); and 19 cUTI (8.8%). Doripenem MIC90 values for Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae were 32, 32, 0.094 and 0.64µg/mL, respectively. Doripenem was used most commonly as monotherapy (86.6%) and as second-line therapy (62.0%). The clinical cure rate in clinically evaluable patients was 86.7% at the end of therapy (EOT) and 87.1% at test of cure (TOC) (7-14 days after EOT). In the ITT population, overall clinical cure rates were 66.2% at EOT and 56.5% at TOC. The median duration of hospital stay, intensive care unit (ICU) stay and mechanical ventilation was 20, 12 and 10 days, respectively. Of 146 discharged patients, 7 were re-admitted within 28 days of EOT; 1 VAP patient was re-admitted to the ICU. The all-cause mortality rate was 22.7% (49/216). The most common treatment-related adverse events were diarrhoea (1.4%) and vomiting (1.4%). Doripenem is a viable option for treating APAC patients with NP, VAP, cIAI or cUTI. [ClinicalTrials.gov: NCT 00986102].


Subject(s)
Anti-Bacterial Agents/therapeutic use , Carbapenems/therapeutic use , Intraabdominal Infections/drug therapy , Pneumonia, Ventilator-Associated/drug therapy , Urinary Tract Infections/drug therapy , Acinetobacter Infections/drug therapy , Acinetobacter baumannii/drug effects , Acinetobacter baumannii/pathogenicity , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/adverse effects , Anti-Bacterial Agents/blood , Asia , Carbapenems/adverse effects , Carbapenems/blood , Doripenem , Escherichia coli/drug effects , Escherichia coli/pathogenicity , Escherichia coli Infections/drug therapy , Female , Humans , Intensive Care Units , Intraabdominal Infections/microbiology , Intraabdominal Infections/mortality , Klebsiella Infections/drug therapy , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/pathogenicity , Male , Middle Aged , Pneumonia, Ventilator-Associated/microbiology , Pneumonia, Ventilator-Associated/mortality , Prospective Studies , Pseudomonas Infections/drug therapy , Pseudomonas aeruginosa/drug effects , Pseudomonas aeruginosa/pathogenicity , Treatment Outcome , Urinary Tract Infections/microbiology , Urinary Tract Infections/mortality , Young Adult
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