Clinical efficacy and safety of high-dose doripenem in Japanese patients with pneumonia

J Infect Chemother. 2016 Mar;22(3):137-42. doi: 10.1016/j.jiac.2015.11.011. Epub 2016 Jan 14.

Abstract

Background: Pneumonia is now the third leading cause of death in Japan, and the number of patients with pneumonia is expected to increase with the progression of aging of the country. Higher dosage of antibiotics has recently been used, and high-dose doripenem (DRPM; 3 g daily) was approved for use in Japan in April 2011. However, there is a lack of data regarding the efficacy and safety of high-dose DRPM in Japan. This study prospectively assessed the clinical efficacy and safety of high-dose DRPM in Japanese patients with refractory pneumonia.

Methods: This study was performed at University of Occupational and Environmental Health, Japan and affiliated hospitals. The efficacy and safety of DRPM in patients with pneumonia treated with 3 g daily of DRPM, including those in whom DRPM dosage was increased from 1.5 g to 3 g daily, were evaluated.

Results: The safety evaluations included 56 patients, and the efficacy was evaluated in 51 patients. DRPM (3 g daily) treatment showed the response rate of 92.2% (47/51). Adverse effects of DRPM (3 g daily) were observed in 11 of 56 patients (19.7%), and all of these patients improved after DRPM cessation. Two patients had to stop DRPM administration due to elevated aminotransferase levels. The efficacy of DRPM in patients with pneumonia in whom DRPM was increased from 1.5 g daily to 3 g daily was 84.6% (11/13).

Conclusions: High-dose DRPM (3 g daily) treatment is effective and relatively safe in Japanese patients with pneumonia.

Keywords: Carbapenem; Doripenem; Efficacy; High dose; Pneumonia; Safety.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents* / administration & dosage
  • Anti-Bacterial Agents* / adverse effects
  • Anti-Bacterial Agents* / therapeutic use
  • Carbapenems* / administration & dosage
  • Carbapenems* / adverse effects
  • Carbapenems* / therapeutic use
  • Doripenem
  • Female
  • Humans
  • Japan / epidemiology
  • Male
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Bacterial / epidemiology
  • Prospective Studies
  • Sputum / microbiology
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Doripenem