Drug Design, Development and Therapy (Sep 2017)
Extended infusion versus intermittent infusion of imipenem in the treatment of ventilator-associated pneumonia
Abstract
Mohamed M Ibrahim,1 Tarek Fouad Tammam,2 Mohy El Deen Ebaed,3 Hatem A Sarhan,4 Gamal F Gad,5 Amal K Hussein4 1Department of Clinical Pharmacy, Faculty of Pharmacy, Minia University, Minia, Egypt; 2Department of Anesthesia and Intensive Care, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; 3Department of Biochemistry, Egyptian Ministry of Interior, Cairo, Egypt; 4Department of Pharmaceutics, 5Department of Microbiology and Immunology, Faculty of Pharmacy, Minia University, Minia, Egypt Background: Mechanical ventilation support can be the main source of ventilator-associated pneumonia (VAP). VAP is a serious infection that may be associated with dangerous gram-negative bacteria mainly, and it leads to an increase in the mortality in the intensive care unit (ICU). Imipenem is one of the strongest antibiotics now available for treating VAP which is associated with gram-negative and gram-positive bacteria, and it belongs to beta-lactam antibiotic group (carbapenem).Objective: This study tried to investigate the efficacy of imipenem against VAP when it was infused within 180 min versus the efficacy when it was infused within 30–60 min.Setting: This study was conducted in main ICU in general hospital which consists of surgical and medical beds within 2 years. One hundred and eighty-seven patients were enrolled on it.Method: This study is a retrospective cohort which was conducted within 2 years. The efficacy of imipenem which was administered by intermittent infusion (30–60 min) within first year was compared with the efficacy of imipenem which was administered by extended infusion (180 min) within second year in the field of VAP curing and cost reduction. All data were collected retrospectively from patient medical files and were statistically analyzed by SPSS version 20.Main outcome: The study was designed to measure clinical and cost reduction outcomes, mortality and hospital stay.Results: The results indicated that there is a significant decrease in mortality, number of recurrent infection, and ICU stay length, and the number of mechanical ventilator days was associated with extended imipenem infusion during the second year of the study.Conclusion: The use of imipenem with extended infusion over 3 hours enhances its clinical outcomes in the treatment of VAP. Keywords: carbapenem, imipenem, VAP, extended infusion, intermittent infusion
