WASHINGTON — Diabetic patients with severe skin infections had greater improvement when treated with meropenem than with imipenem-cilastatin, Dr. John M. Embil reported in a poster presented at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy.
Skin and skin-structure infections are a perpetual problem for many diabetic patients, and may require surgical intervention if left untreated, wrote Dr. Embil of the University of Manitoba, Winnipeg, Canada.
The international, randomized, double-blind study included 1,037 hospitalized patients with complicated skin infections, 398 of whom were diabetic.
The clinical cure rate was 86% among the 204 diabetic patients who received a 500-mg intravenous dose of meropenem every 8 hours, compared with 72% among the 194 diabetic patients who received the same dosing regimen of imipenem-cilastatin. The cure rate among the nondiabetic patients treated with meropenem (87%) was similar to the rate in those treated with imipenem-cilastatin (89%).
Overall, meropenem was associated with slightly higher cure rates for all groups of pathogens—aerobic gram-negative, aerobic gram-positive, anaerobic, and polymicrobial—compared with imipenem-cilastatin, but the differences were not statistically significant. More than 40% of the pathogens were gram-negative aerobic or anaerobic organisms, and 29% of the Staphylococcus aureus isolates showed methicillin resistance. A similar spectrum of pathogens appeared in both diabetic and nondiabetic patients.
The study was sponsored in part by AstraZeneca, and the meeting was sponsored by the American Society for Microbiology.