The efficacy, safety, and pharmacokinetics of biapenem administered thrice daily for the treatment of pneumonia in the elderly.

Biapenem has been widely used to treat bacterial pneumonia; however, there is little information concerning its efficacy and safety in elderly patients. Based on pharmacokinetic-pharmacodynamic theory, administration of biapenem thrice rather than twice daily would be expected to be more effective because of longer time above the minimum inhibitory concentration. In this study, we aimed to evaluate the efficacy, safety, and pharmacokinetics of biapenem (300 mg) administered thrice daily in pneumonic patients aged 65 years or older. Biapenem was effective in 22 of 25 patients, as assessed by the improvement in clinical symptoms and/or the eradication of the causative organisms, and caused no serious adverse events. The pharmacokinetic profile was established based on simulations using a modeling program. Among 17 patients whose causative organisms were detected, time above the minimum inhibitory concentration was estimated to be 100% in 16 patients, all of whom showed clinical improvement. The results of this study confirmed the efficacy and safety of 300 mg of biapenem administered thrice daily for the treatment of pneumonia in elderly patients.

[Two cases of long-term response treated by S-1 with concurrent radiotherapy followed by S-1 treatment for non-small cell lung cancer patients].

In a previous study, we reported a patient who responded to non-small cell lung cancer treatment with S-1 and concurrent radiotherapy over an extended period. This time, we report a long-term follow-up of the same case, and a new case which had a complete response to S-1 and concurrent radiotherapy. Case 1 is a 35-year-old woman with a pathological diagnosis of stage T2N2M0 lung adenocarcinoma. This case was already reported till 36 months postoperatively. 71 months postoperatively, PET-CT inspection revealed no obvious metastasis, unusual accumulations of FDG, or unusual shadows which may suggest recurrence. Case 2 is a 37-year-old woman with a pathological diagnosis of stage T2N2M0 right lung adenocarcinoma. After CBDCA/GEM and gefitinib were used as anterior chemotherapies, the right lung was partially resected. However, since the metastasis was developed, a total amount of 60 Gy/30 Fr was used to irradiate the mediastinum of the right cervix. Around the same time, S-1 treatment was started[a dose of 50mg/day(35m2/day)in two divided doses for 2 weeks, followed by 1 week of rest). As a result of S-1 treatment with concurrent radiotherapy, the patient had a long-term response. Sixteen months postoperatively, there has been no observable recurrence by CT inspection.