[Antibiotic therapy of infections in patients under surgical intensive care, in particular with mezlocillin (author's transl)]

Abstract

Twenty-two patients from our surgical intensive care ward were, after unsuccessful treatment outside, treated with a combination of antibiotics including 6-[(R)-2-[3-methylsulfonyl-2-oxo-imidazolidine-1-carboxamido]-2-phenyl-acetamido]-penicillanic acid sodium salt (mezlocillin, Baypen) as a beta-lactam antibiotic. The infection was cured in 16 and improved in 2 patients. Three cases of infection with Serratia did not respond to treatment and antibacterial efficacy was unassessable in another case. Four patients died of shock lung (2), pulmonary embolism (1) or Candida-induced septicaemia (1) after cure of the infection. The daily dose of mezlocillin was 3 x 5 g, given as an i.v. short-term infusion. Diarrhoea (1) and petechiae (1) were observed as side effects probably attributable to mezlocillin. In none of the patients was a discontinuation of treatment necessary. Owing to its broad spectrum of action (covering both gram-positive and gram-negative microorganisms and anaerobes) and its consistently strong molar action, mezlocillin is well suited as a beta-lactam combination component for intensive care patients. At the end of this study in vitro resistant strains appeared. Therefore mezlocillin with its very valuable properties should be given only to critically selected cases.