The effect of imipenem/cilastatin on the aerobic faecal flora of children

Abstract

In 18 children treated with imipenem iv, quantitative cultures for aerobic faecal flora were performed on selective media (before, when possible, during and after treatment). In ten children who had not received previous antibiotic therapy, susceptible enterobacteria could be detected at a normal level throughout treatment. Eight children had received other antibiotics beforehand; during the first week of imipenem therapy, enterobacteria were undetectable in two and at low levels in three patients. In one patient previously treated with aztreonam, a strain of Pseudomonas aeruginosa became resistant to imipenem and increased in numbers. No dramatic change could be detected in group D streptococci, staphylococci or candida. The surprisingly small effect of imipenem on faecal Enterobacteriaceae could be explained by its inconstant presence in stools at the dose administered.