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CHEMOTHERAPY APRIL 1992 Table 2. Concentration of meropenem in human prostatic fluid Table 1. Background of 21 chronic complicated UTI cases * NB + BPH, NB + Kidney tumor, NB + Kidney tuberculosis

Table 3-1. Clinical summary of complicated UTI patients treated with meropenem CCC: chronic complicated cystitis GNB: gram-negative bacilli 1) LDH (388 609) CCP: chronic complicated pyelonephritis 2)LDH (401 601) GPC: gram-positive cocci BPH: benign prostatic hypertophy GNFGNR: glucose nonfermenting gram-negative rods CNS: coagulase-negative staphylococci * Before treatment NT: not tested After treatment

CHEMOTHERAPY APRIL 1992 Pseudomonas aeruginosa Enterococcus faecalis Table 3-2. Clinical Summary of bacteremia and acute bacterial prostatitis treated with meropenem Before After treatment treatment 1) Blood culture 2) EPS culture ND: not detected Table 4. Overall clinical efficacy of meropenem in complicated UTI Bacteriological response regardless of bacterial count

Table 6. Bacteriological response to meropenem in complicated UTI regardless of bacteria count CNS: coagulase-negative Staphylococci GPC: gram-negative cocci GNFGNR: glucose nonfermenting gram-negative rods Table 5. Overall clinical efficacy of meropenem classified by type of infection

CHEMOTHERAPY APRIL 1992 * regardless of bacteria count Table 7. Strains* appearing after meropenem treatment in complicated UTI GNB: gram-negative bacilli YLO: yeast-like organism Fig. 1. Bacteriokinetic study of meropenem in chronic completed UTI (1,000 mg administration once a day).

Fig. 2. Bacteriological/clinical response to meropenem in 2 cases of acute bacterial prostatitis.

CHEMOTHERAPY APRIL 1992 11) Vogelmau B and Craig W A: Kinetics of antimicrobial activity: J. Pediatr: 108, 835-840, 1986 13) Drew J W: Imipenem Therapy of P. aeruginosa and Serious Bacterial Infections. Antimicrobial Agents & Chemotherapy 26: 673 `677, 1984

LABORATORY AND CLINICAL STUDIES OF MEROPENEM IN UROLOGICAL INFECTION Keizo Suzuki and Masaki Horiba Department of Urology, Hiratsuka Municipal Hospital 1-19-11 Minamihara, Hiratsuka 254, Japan Yorio Naide and Hideo Hibi Department of Urology, School of Medicine, Fujitagakuen University Laboratory and clinical studies were carried out on the effects of meropenem (MEPM) in urological field infections, and the results were as follows. 1. Concentration in prostatic fluid (PF): One hour after the administration of 500 mg of MEPM by ivd, the concentration in PF reached 1.04+ 0.75 iug/m1 (n=3), and the ratio between serum and PF was 0.06 + 0.06. 2. Clinical results: Twenty-five patients, including 21 cases of chronic complicated UTI, 2 of bacteremia and 2 of acute bacterial prostatitis, were treated at doses of 500 2000 mg a day. In complicated UTI, the clinical efficacy was excellent or moderate in 17 of 21 patients (81%). In 13 strains of 6 species of GPC, and 14 strains of 8 species of GNB, 93% of bacteria were eradicated after treatment. Against 2 cases of bacteremia and 2 cases of acute bacterial prostatitis, administration started at a dose of 500 mg every 6 hours. Then the dose was decreased gradually to 1000 mg a day at 7 days, and excellent clinical results were obtained. Four patients showed abnormal values in liver function, and mild transient vomiting was noted at the first administration in one case.

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