Infect Chemother.  2015 Sep;47(3):175-180. 10.3947/ic.2015.47.3.175.

In vitro Antibacterial Activity of Doripenem against Gram-Negative Blood Isolates in a Korean Tertiary Care Center

• Choi SH
• Ahn MY
• Chung JW
• Lee MK

• KMID: 2068982
• DOI: http://doi.org/10.3947/ic.2015.47.3.175

Abstract

BACKGROUND
Doripenem is the most recently introduced antimicrobial agent of the carbapenem class. It is a valuable therapeutic option in the context of increasing antimicrobial resistance to imipenem and meropenem among gram-negative bacilli (GNB) clinical isolates. However, clinicians are usually reluctant to prescribe doripenem, because susceptibility to doripenem is not automatically reported by most clinical laboratories and the in vitro activity of doripenem against clinically significant GNB isolates remains uncertain.
MATERIALS AND METHODS
We investigated the in vitro antibacterial activity of doripenem in GNB blood isolates in a tertiary care center. Over a period of 10 months, 212 adult bacteremia cases were treated at the study hospital. Doripenem susceptibility testing was performed for the 212 blood isolates by the disk diffusion method, and clinical data were collected.
RESULTS
Among the blood isolates, the rate of doripenem resistance (7.5%) was lower than that of imipenem (12.9%) or other anti-GNB antimicrobial agents, except amikacin (2.1%). Almost all imipenem-susceptible GNB blood isolates (181/182, 99.5%) were susceptible to doripenem. Whereas doripenem resistance was rarely observed in Enterobacteriaceae (2/181, 1.1%), it was frequently observed in patients with non-fermentatative GNB (12/27, 44.4%), hospital-acquired infections (7/27, 25.9%), and pneumonia (11/49, 22.4%).
CONCLUSION
Doripenem exhibited more potent in vitro activity against GNB blood isolates than other anti-GNB antimicrobial agents in a tertiary care center where it was infrequently prescribed compared with other carbapenems. However, its clinical utility may be limited due to the increasing number of carbapenem-resistant non-fermentative GNB infections.

Keyword

Doripenem; Gram-negative bacteria; Bacteremia

MeSH Terms

Adult
Amikacin
Anti-Infective Agents
Bacteremia
Carbapenems
Diffusion
Enterobacteriaceae
Gram-Negative Bacteria
Humans
Imipenem
Pneumonia
Tertiary Care Centers*
Tertiary Healthcare*
Amikacin
Anti-Infective Agents
Carbapenems
Imipenem

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