"We encourage physicians to hit hard against these severe infections in the intensive care unit while they are waiting for laboratory confirmation of which pathogens they are working against," said Jordi Rello, M.D., of the University Hospital Joan XXIII in Tarragona, Spain, one of the forum participants.

Once laboratory results are available and the pathogen is identified, physicians can either maintain the initial therapy or "de-escalate" to other regimens, Dr. Rello said. Imipenem/cilastatin sodium is successful in the treatment of mixed infections because of its broad activity against gram-positive and gram-negative aerobic and anaerobic bacteria.

"The key is to address these resistant infections right away. Failure to hit hard in the early stages of therapy will lead to increased mortality," Dr. Rello said. "However, initial adequate therapy with a broad-spectrum agent such as imipenem/cilastatin sodium can not only reverse the course of these infections but save lives as well."

The most frequently reported side effects of imipenem/cilastatin sodium are nausea, diarrhea, vomiting, rash, fever, hypertension, seizures and dizziness.

George Karam, M.D., Professor of Medicine at the Louisiana State University School of Medicine in New Orleans, said the Philadelphia symposium, "De-Escalation Therapy: Initial Adequate Therapy for Serious Infection," represents an "impressive assembly of global experts" to discuss hospital-based infections. "This forum allows us to take existing information and synthesize it in a way that will assist physicians in their approach to the diagnosis and treatment of nosocomial (hospital-based) pneumonia," he said. "One of the most exciting opportunities of this panel is to further define the concept of De-Escalation Therapy, where broad spectrum antibiotics are administered first in critically ill patients to prevent rapid decline, avoid resistance, and save lives."

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