Empirical use of imipenem as the sole antibiotic in the treatment of serious infections

Seventy-three patients with eighty-five infections were treated with imipenem as the sole antimicrobial agent. Some of these infections were caused by pseudomonads and enterococci resistant to other cephalosporins. The vast majority of the Gram-positive and the Gram-negative bacteria that were isolated had a minimal inhibitory concentration (MIC) of less than 1 mg/l, and all MICs for initial isolates were below the levels of imipenem that were achieved in plasma and other body fluids with a dose of 500 mg every 6 h. The outcomes of 67 infectious episodes were satisfactory, four outcomes were failures and 14 were not evaluable. During the two years of this study, only a few strains of Staphylococcus epidermidis and of Pseudomonas aeruginosa emerged which were resistant to imipenem.