Clinical research in the lay press: irresponsible journalism raises a huge dose of doubt.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to George Drusano.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The usefulness of many beta-lactams, including the third-generation cephalosporins, has been threatened in recent years by the dissemination of beta-lactamase-mediated resistance. The carbapenems, meropenem and imipenem/cilastatin, demonstrate ultra-broad spectra of antibacterial activity which encompass the majority of clinically significant Gram-positive and Gram-negative aerobic and anaerobic pathogens. Due to the unique arrangement of the moieties around the carbapenem beta-lactam ring, these agents possess unrivaled stability to almost all serine beta-lactamases, including the mutant extended-spectrum types produced by Enterobacteriaceae which hydrolyze third-generation cephalosporins. Meropenem has a number of additional structural features which confer advantages over imipenem, notably stability to metabolism by dehydropeptidase-I and enhanced activity against Gram-negative organisms, including Pseudomonas aeruginosa. In the treatment of nosocomial respiratory tract infections, meropenem monotherapy has compared favorably with ceftazidime plus aminoglycoside combination regimens or imipenem/cilastatin, producing rates of clinical efficacy of > 75%. Likewise, in patients with intra-abdominal infections, meropenem has proved to be as efficacious as clindamycin plus tobramycin, cefotaxime plus metronidazole and equivalent dosages of imipenem/cilastatin. Meropenem is well tolerated by the central nervous system and, unlike imipenem/cilastatin, is approved for the treatment of meningitis.