A dose-finding study of doripenem in patients with complicated urinary tract infection

Accession number;05A0663327
Title;A dose-finding study of doripenem in patients with complicated urinary tract infection
Author; KAMIDONO SADAO (Kobe Univ., School of Medicine, JPN) ARAKAWA SOICHI (Kobe Univ., School of Medicine, JPN) KUMON HIROMI (Okayama Univ., Medical School, JPN) MATSUMOTO TETSURO (Kyudai I Hinyokika) NAKASHIMA MITSUYOSHI (Fac. Medicine, Hamamatsu Univ. School of Medicine, JPN) KATAOKA NOBUMASA (Kobe Univ., School of Medicine, JPN) SHIMADA JINGORO (St. Marianna Univ. School of Medicine, JPN)
Journal Title;Japanese Journal of Chemotherapy
Journal Code:F0608A
ISSN:1340-7007
VOL.53;NO.Supplement 1;PAGE.230-243(2005)
Figure&Table&Reference;FIG.4, TBL.15, REF.10
Pub. Country;Japan
Language;Japanese
Abstract;We conducted a dose finding study of doripenem (DRPM), a new carbapenem antibiotic for injection, in patients with complicated urinary tract infections to evaluate the safety and efficacy of DRPM at the recommended dose of 250 mg b.i.d. (250 mg group). DRPM was also evaluated at a high dose of 500 mg b.i.d. (500 mg group) to show that the dose of 250 mg b.i.d. is appropriate therapeutically. Subjects were inpatients aged between 20 and 79 years shown to have pyuria of at least 5 WBCs/hpf and bacteriuria of at least l0'4' CFU/mL. In patients with previous prostatic resection, an interval of more than 6 months after surgery was required for inclusion. Patients with indwelling catheters were excluded. Overall efficacy (primary endpoint) was 97.4% (37/38) in the 250 mg group and the 95% confidence interval was 86.2% to 99.9%. This efficacy was not below the minimuml 95% confidence interval (78.6%-98.3%) for expected efficacy (90%) and was still higher than expected efficacy. In the 500 mg group, overall efficacy was 96.9% (31/32) and no significant difference was seen between groups. For secondary endpoints, no significant difference was seen between groups: 1) effect on pyuria was 60.5% in the 250 mg group and 75.0% in the 500 mg group, 2) effect on bacteriuria was 94.7% in the 250 mg group and 84.4% in the 500 mg group, 3) bacteriological response was 95.7% in the 250 mg group and 97.7% in the 500 mg group, and 4) clinical efficacy judged by attending urologists was 94.7% in the 250 mg group and 84.4% in the 500 mg group. These results showed that efficacy at 250 mg b.i.d. was equivalent to that at 500 mg b.i.d.. For safety, the incidence of adverse drug reactions (symptoms) was 4.9% in the 250 mg group and 2.9% in the 500 mg group, respectively, and the incidence of adverse drug reactions (abnormal laboratory findings) 15.4% and 15.2%, with no significant difference seen between groups in either case.... (author abst.)