Meropenem vs imipenem plus cilastatin for severe infections

Meropenem is at least as effective as imipenem plus cilastatin for severe infections, and it may cause fever adverse effects.

A systematic review including 27 studies with a total of more than 3800 subjects was abstracted in DARE. Bacteriologic response (22 RCTs) was statistically significantly higher for meropenem than imipenem plus cilastatin (RR 1.05, 95% CI 1.01 to 1.08). There was no statistically significant difference in mortality over the course of treatment between meropenem and imipenem plus cilastatin (9 RCTs; RR 0.98, 95% CI 0.71 to 1.35). There were statistically significantly fewer adverse events with meropenem than with imipenem plus cilastatin (18 RCTs; RR 0.87, 95% CI: 0.77 to 0.97).

Comment: The inclusion criteria of most of the included trials required that only patients expected to survive the treatment period be randomised, therefore, the included trials were less likely to report a statistically significant difference in mortality. This review was supported by AstraZeneca UK Ltd., the distributor of meropenem in the UK.

Ədəbiyyat

1. Edwards SJ, Emmas CE, Campbell HE. Systematic review comparing meropenem with imipenem plus cilastatin in the treatment of severe infections. Curr Med Res Opin 2005 May;21(5):785-94.