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Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e31828be70b
Antimicrobial Reviews

Adverse Events Associated With Meropenem Versus Imipenem/Cilastatin Therapy in a Large Retrospective Cohort of Hospitalized Infants

Hornik, Christoph P. MD, MPH*†; Herring, Amy H. ScD; Benjamin, Daniel K. MD, PhD, MPH*†; Capparelli, Edmund V. PharmD§; Kearns, Gregory L. PharmD, PhD; van den Anker, John MD, PhD; Cohen-Wolkowiez, Michael MD, PhD*†; Clark, Reese H. MD**; Smith, P. Brian MD, MPH, MHS*†

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Abstract

Background:

Carbapenems are commonly used in hospitalized infants despite a lack of complete safety data and associations with seizures in older children. We compared the incidence of adverse events in hospitalized infants receiving meropenem versus imipenem/cilastatin.

Methods:

We conducted a retrospective cohort study of 5566 infants treated with meropenem or imipenem/cilastatin in neonatal intensive care units managed by the Pediatrix Medical Group between 1997 and 2010. Multivariable conditional logistic regression was performed to evaluate the association between carbapenem therapy and adverse events, controlling for infant factors and severity of illness.

Results:

Adverse events were more common with use of meropenem compared with imipenem/cilastatin (62.8/1000 infant days versus 40.7/1000 infant days, P < 0.001). There was no difference in seizures with meropenem versus imipenem/cilastatin (adjusted odds ratio 0.96; 95% confidence interval: 0.68, 1.32). The incidence of death, as well as the combined outcome of death or seizure, was lower with meropenem use—odds ratio 0.68 (0.50, 0.88) and odds ratio 0.77 (0.62, 0.95), respectively.

Conclusion:

In this cohort of infants, meropenem was associated with more frequent but less severe adverse events when compared with imipenem/cilastatin.

Copyright © 2013 by Lippincott Williams & Wilkins

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