Imipenem/cilastatin: a multicentre international study of its clinical efficacy, safety and potential as empirical therapy.

Five hundred and sixty-nine patients were treated with imipenem/cilastatin in this multicentre, international noncomparative study of hospitalized patients with moderate to severe infections; 97.5% of 815 pathogens isolated were susceptible to imipenem, which reconfirms imipenem's broad in-vitro spectrum. Clinical efficacy could be assessed in 389 patients, the majority (72%) of whom received a daily dose of 1.5 g or less. Infections in the various body sites with the exception of the central nervous system were treated. A favourable clinical outcome was seen in 93% of the infections. Fifty-five of the 389 patients had been unsuccessfully treated with one or more antibiotics before being switched to imipenem/cilastatin. In these patients the daily dose was evenly distributed between 1.5 g/day (47%) or 2.0 g/day (40%); the rest of the patients received greater than 2 g/day. Intra-abdominal and respiratory tract infections were the most common, the majority (56%) of which were rated severe. Overall clinical efficacy (cured or improved) in these 55 patients was 82%. With the demonstrated clinical efficacy, particularly in the treatment of proven infections which have failed on other regimens, imipenem/cilastatin could have a distinct advantage as an initial choice for empirical therapy.