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Journal of Antimicrobial Chemotherapy (1988) 22, 765-770
© 1988 The British Society for Antimicrobial Chemotherapy

research-article

Imipenem/cilastatin as initial therapy for febrile neutropenic patients

Raymond Lianga, Raymond Yungb, P. Y. Chaub, T. K. Chana, W. K. Lama, S. Y. Soa and David Todda

aDepartments of Medicine, University of Hong Kong, Queen Mary Hospital Hong Kong bDepartments of Microbiology, University of Hong Kong, Queen Mary Hospital Hong Kong

Received 7 April 1988; returned 27 June 1988; accepted 27 June 1988

Imipenem 2 g daily was administered intravenously to 40 evaluable patients with neutropenia and fever. Twenty-three patients had acute leukaemia and 17 malignant lymphoma. The overall response rate was 70.0%. Of the 14 patients with documented infection, 9 (64.3%) responded. Poorer responses were observed in patients with pneumonia (40%) or pseudomonal infection (50%). The response rate was significantly higher among patients with increasing neutrophil counts during therapy (P < 0.02). Fungal infection was a common cause of treatment failure. Gastrointestinal side effects and skin rashes were occasionally seen. No patient developed central nervous system toxicity. Imipenem is a practical alternative to antibiotic combinations for management of neutropenic infection. However, careful monitoring is essential in the subgroups of patients with pneumonia or pseudomonal infections, who may require modifications of therapy.


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