[Efficacy of injectable carbapenems for respiratory infections caused by Streptococcus pneumoniae and Haemophilus influenzae with Monte Carlo simulation].

Streptococcus pneumoniae and Haemophilus influenzae are two major pathogens for respiratory tract infections, and those infections might cause critically ill patients. We performed the analysis with Monte Carlo Simulation for 253 strains of S. pneumoniae and 309 strains of H. influenzae isolated in the Gifu prefecture in 2002 and 2003. As for the pneumococcal infection in patient with good immunological response, good clinical effect might be obtained by panipenem/betamipron (PAPM/BP) 500 mg, imipenem/cilastatin (IPM/CS) 500 mg, meropenem (MEPM) 500 mg and biapenem (BIPM) 300 mg, b.i.d., while for immunocompromised hosts or infections by penicillin-resistant Streptococcus pneumoniae (PRSP), PAPM/BP, 500 mg, b.i.d., or IPM/CS 500 mg, MEPM 500 mg, t.i.d. or BIPM 600 mg, b.i.d. would be recommended. As for the infections caused by H. influenzae, in patient with good immunological response, good clinical effect might be obtained by MEPM 500 mg, b.i.d or PAPM/BP 1000 mg, b.i.d., while for immunocompromised hosts, MEPM 500 mg, t.i.d. would be recommended. Monte Carlo Simulation would be one of the useful tools for appropriate antimicrobial chemotherapy also against respiratory infections.