Multicenter randomized trial comparing meropenem (1.5 g daily) and imipenem/cilastatin (2 g daily) in the hospital treatment of community-acquired pneumonia

An open, multicenter study with 144 patients, aged between 18 and 94 years, was performed to compare the efficacy and safety of meropenem with imipene m/cilastatin in the hospital treatment of community-acquired pneumonia. Pat ients were randomized to receive either intravenous meropenem (500 mg every 8 h) or intravenous imipenem/cilastatin (1,000 mg every 12 h). The primary end point was considered to be clinical efficacy and the secondary end poi nts were bacteriobiological response and safety assessment. At the end of t herapy cure or improvement in signs and symptoms as a satisfactory clinical response was observed in 57 of 64 (89.1%) meropenem-treated patients and i n 60 of 66 (90.9%) imipenem/cilastatin patients. The mean duration of treat ment was 10 days for meropenem and 9.7 days for imipenem/cilastatin. In pat ients who were followed up for weeks 2-4, the response was satisfactory (10 0%) for both treatments. A satisfactory bacteriological response, defined a s either presumed or confirmed eradication of ail pathogens, was found in e ight patients who had received meropenem and in 14 patients who had receive d imipenem/cilastatin. Response was considered satisfactory in 100% of the meropenem group and in 92.9% of the imipenem/cilastatin group and at follow -up, it was 100% for both treatments Drug-related adverse events were repor ted in three (4.2%) meropenem-treated patients and in eight (11,0%) imipene m/cilastatin-treated patients. None of these events was classified as serio us. The results of this study show that the clinical and bacteriological ef ficacy and tolerability of meropenem (500 mg every 8 h) are similar to that of imipenem/cilasiatin (1,000 mg every 12 h) in the hospital treatment of community-acquired pneumonia.