FrancophonIA/ELRC3.0 huggingface dataset:
English: In particular, four divergent indications (i.e., gynaecological infections, septicaemia, bone and joint infections, and endocarditis) and the use in paediatric patients less than 3 years of age were discussed.
Slovenian: Razpravljali so predvsem o štirih različnih indikacijah (tj. o ginekoloških okužbah, septikemiji, okužbah kosti in sklepov ter endokarditisu) in uporabi pri pediatričnih bolnikih, mlajših od treh let.
English: The CHMP also discussed the possibility of limiting the indication to “Osteomyelitis” however there were not enough data to support this indication.
Slovenian: CHMP je razpravljal tudi o možnosti omejitve indikacije na „osteomielitis“, vendar ni bilo dovolj podatkov, ki bi to indikacijo podprli.
English: The CHMP also deleted the low doses of 250 mg every 6 hours as mild infections should not be treated with imipenem/cilastatin.
Slovenian: CHMP je tudi izbrisal majhne odmerke v višini 250 mg vsakih 6 ur, saj se blage okužbe naj ne bi zdravile z imipenemom/cilastatinom.
English: “severe pneumonia including hospital and ventilator-associated pneumonia”
Slovenian: „huda pljučnica, vključno z bolnišnično pridobljeno in z ventilatorji povezano pljučnico“
English: With regards to safety, the CHMP considered that the available documentation supports a similar safety profile of imipenem/cilastatin in children compared to adults.
Slovenian: Glede varnosti je CHMP menil, da razpoložljiva dokumentacija pri otrocih podpira podoben varnostni profil imipenema/cilastatina kot pri odraslih.
English: The overall clinical efficacy of imipenem/cilastatin was high and evaluable patients and the used dosage was effective and safe.
Slovenian: Splošna klinična učinkovitost imipenema/cilastatina je bila pri ovrednotenih bolnikih visoka, uporabljeni odmerek pa je bil učinkovit in varen.
English: 4.1.10 Management of bacterial infections in patients with febrile neutropenia
Slovenian: 4.1.10 Zdravljenje bakterijskih okužb pri bolnikih s febrilno nevtropenijo
English: However, the CHMP acknowledged that high clinical cure rates were reported in a large number of patients with bacteraemia associated with the approved indications.
Slovenian: CHMP je kljub temu upošteval poročila o visoki stopnji klinične ozdravitve pri velikem številu bolnikov z bakteriemijo, povezano z odobrenimi indikacijami.
English: Concomitant use of an aminoglycoside may be indicated when Pseudomonas aeruginosa infections are suspected or proven to be involved in the approved indications (see section 4.1).”
Slovenian: Sočasna uporaba aminoglikozida je lahko indicirana, kadar obstaja sum, da je okužba z bakterijo Pseudomonas aeruginosa vključena v odobrene indikacije ali pa je to dokazano (glejte poglavje 4.1).“
English: The MAH provided a cumulative review of adverse event reports received for imipenem/cilastatin in paediatric patients between 3 months to 3 years of age, which identified a total of 163 events in 82 reports.
Slovenian: Imetnik dovoljenja za promet z zdravilom je predložil kumulativni pregled poročil o neželenih učinkih imipenema/cilastatina pri pediatričnih bolnikih, starih od treh mesecev do treh let, v katerem je bilo opredeljenih 163 dogodkov v 82 poročilih.
English: The CHMP also noted the additional information in the form of abstracts or brief publications and considered that an indication for complicated intra-abdominal infections was supported.
Slovenian: CHMP je upošteval tudi dodatne informacije v obliki izvlečkov ali kratkih publikacij in menil, da je indikacija za zapletene intraabdominalne okužbe potrjena.
English: In conclusion, the CHMP adopted a harmonised wording for section 4.2, including the following dose recommendations:
Slovenian: CHMP je posledično sprejel usklajeno besedilo za poglavje 4.2 in vključil naslednja priporočila o odmerjanju:
English: The CHMP noted the proposed indication “mixed infections” but was of the opinion that this wording is not in line with the current antimicrobial guidelines and recent European regulatory decisions, which require a site of infection to be specified.
Slovenian: CHMP je upošteval predlagano indikacijo „mešane okužbe“, vendar je menil, da besedilo ni usklajeno z veljavnimi protimikrobnimi smernicami in novejšimi evropskimi regulatornimi odločitvami, ki zahtevajo določitev mesta okužbe.
English: In conclusion, the CHMP adopted the following harmonised indication:
Slovenian: CHMP je posledično sprejel naslednjo usklajeno indikacijo:
English: 4.1.4 Septicaemia
Slovenian: 4.1.4 Septikemija
English: Although most studies were outdated and/or of poor quality, the CHMP was of the opinion that a restricted indication would be justified and in conclusion, adopted the following harmonised indication:
Slovenian: Čeprav je bila večina študij zastarelih in/ali slabe kakovosti, je CHMP menil, da bi bila omejena indikacija upravičena, zato je posledično sprejel naslednjo usklajeno indikacijo:
English: Imipenem has activity against a wide variety of bacteria, including Grampositive aerobic cocci, Gram-positive aerobic bacilli, Gram-negative aerobic bacteria, and anaerobes.
Slovenian: Imipenem deluje proti raznovrstnim bakterijam, vključno proti grampozitivnim aerobnim kokom, grampozitivnim aerobnim bacilom, gramnegativnim aerobnim bakterijam in anaerobom.
English: The CHMP adopted a harmonised wording for section 4.4 and in particular, the following statement concerning the limited susceptibility of specific pathogens and the concomitant use of an appropriate anti-MRSA agent or of an aminoglycoside was included:
Slovenian: Sprejel je usklajeno besedilo za poglavje 4.4 in vključil naslednjo izjavo o omejeni občutljivosti specifičnih patogenov ter sočasni uporabi ustreznega zdravila proti bakteriji MRSA ali aminoglikozida:
English: The MAH provided a categorised summary of the enrolled patients, according to age groups to provide a basis for a discussion on the need for limiting the use of imipenem/cilastatin to children above 1 year of age for safety reasons.
Slovenian: Imetnik dovoljenja za promet z zdravilom je predložil kategoriziran povzetek sodelujočih bolnikov glede na starostne skupine in tako zagotovil podlago za razpravo o potrebi po omejevanju uporabe imipenema/cilastatina pri otrocih, starejših od enega leta zaradi varnostnih razlogov.
English: “complicated intra-abdominal infections”
Slovenian: „zapletene intraabdominalne okužbe“.
English: The CHMP therefore considered that the benefit-risk for imipenem/cilastatin in children under 1 year of age is negative and inserted a statement that the clinical data are insufficient to recommend dosing for children under the age of 1 year.
Slovenian: CHMP je tako sklenil, da je razmerje med koristmi in tveganji za imipenem/cilastatin pri otrocih, mlajših od enega leta, negativno in dodal izjavo, da so klinični podatki nezadostni za priporočilo odmerka za otroke, mlajše od enega leta.
English: For paediatric patients ≥1 year of age, the recommended dose is 15 or 25 mg/kg/dose administered every 6 hours.
Slovenian: Za pediatrične bolnike, ki so stari 1 leto ali več, je priporočeni odmerek 15 ali 25 mg/kg/odmerek vsakih 6 ur.
English: Tienam is a broad spectrum antibacterial agent that belongs to the group of carbapenems and consists of a fixed combination (1:1 ratio) of imipenem (a carbapenem antibiotic which is a derivative of thienamycin) and cilastatin (an inhibitor of dehydropeptidase I, a renal enzyme which metabolizes and inactivates imipenem).
Slovenian: Zdravilo Tienam je protibakterijsko zdravilo širokega spektra, ki spada v skupino karbapenemov in je sestavljeno iz fiksne kombinacije (razmerje 1:1) imipenema (karbapenemski antibiotik, ki je derivat tienamicina) in cilastatina (zaviralec dehidropeptidaze I, ledvičnega encima, ki presnavlja in inaktivira imipenem).
English: The use of imipenem/cilastatin is not suitable for treatment of these types of infections unless the pathogen is already documented and known to be susceptible or there is a very high suspicion that the most likely pathogen(s) would be suitable for treatment.
Slovenian: Uporaba imipenema/cilastatina ni primerna za zdravljenje teh vrst okužb, razen kadar je patogen že dokumentiran in znano dovzeten ali obstaja visok sum, da so najverjetnejši patogeni primerni za zdravljenje.
English: The CHMP considered that the frequency of seizures in the paediatric population < 1 year was unacceptably high and that this risk was confirmed by spontaneous adverse event reports.
Slovenian: CHMP je menil, da je pogostnost napadov pri pediatričnih bolnikih, mlajših od enega leta, nesprejemljivo visoka in da so to tveganje potrdila tudi spontana poročila o neželenih učinkih.
English: The CHMP noted the MAH proposal for this section and made a number of revisions.
Slovenian: CHMP je upošteval predlog imetnika dovoljenja za promet z zdravilom za to poglavje in pripravil nekaj popravkov.
English: 4.1.11 Mixed infections
Slovenian: 4.1.11 Mešane okužbe
English: Furthermore, due to the limited susceptibility of specific pathogens associated with e.g. bacterial skin and soft-tissue infections, to imipenem/cilastatin, caution should be exercised.
Slovenian: Zaradi omejene občutljivosti specifičnih patogenov, povezanih z npr. bakterijskimi okužbami kože in mehkih tkiv, za imipenem/cilastatin je potrebna posebna pozornost.
English: 4.1.7 Skin and soft tissue infections
Slovenian: 4.1.7 Okužbe kože in mehkih tkiv
English: The CHMP considered that imipenem/cilastatin is a broad spectrum antibiotic which should be used in the treatment of severe/life-threatening infections accompanying with microbial resistance and/or when microbial resistance is demonstrated.
Slovenian: CHMP je menil, da je imipenem/cilastatin antibiotik širokega spektra, ki se lahko uporablja pri zdravljenju hudih/smrtno nevarnih okužb, ki jih spremlja mikrobna odpornost in/ali kadar se kaže mikrobna odpornost.
English: There were no useful comparator-controlled clinical trials conducted and published in the peer-review literature from 2000 through 2010 in this indication and the epidemiological studies were of questionable quality and not sufficiently informative, in particular with regards to the used imipenem/cilastatin dosage.
Slovenian: Za to indikacijo med leti 2000 in 2010 ni bilo izvedeno nobeno uporabno klinično preskušanje, nadzorovano s primerjalnim zdravilom, in prav tako ni bilo objavljeno v strokovno recenzirani literaturi, epidemiološke študije pa so bile vprašljive kakovosti in niso bile dovolj informativne, zlasti v zvezi z uporabljenim odmerkom imipenema/cilastatina.
English: The CHMP noted that, overall, although no high quality, double blind studies were submitted together with data from a substantial number of randomised, comparative open-labelled studies and concluded that imipenem/cilastatin appears to be suitable for the management of neutropenic patients.
Slovenian: CHMP je upošteval, da so bile predložene dvojno slepe študije, čeprav ne visoko kakovostne, skupaj s podatki iz številnih randomiziranih, primerjalnih odprtih študij, in sklenil, da se je imipenem/cilastatin izkazal kot ustrezen za zdravljenje nevtropeničnih bolnikov.
English: The CHMP noted the proposed indication “endocarditis” but considered that the claimed indication in the treatment of endocarditis was insufficiently substantiated.
Slovenian: CHMP je upošteval predlagano indikacijo „endokarditis“, a je menil, da navedena indikacija za zdravljenje endokarditisa ni bila zadostno utemeljena.
English: The CHMP requested the MAH to carry out a relevant safety analysis across dose levels to confirm that the reason for not recommending the higher dose of 1 g q6h in several indications was not driven by safety aspects.
Slovenian: CHMP je imetnika dovoljenja za promet z zdravilom zaprosil, da izvede ustrezno analizo varnosti z različnimi odmerki, s katero bi potrdili, da razlog za nepriporočljivost odmerka, večjega od 1 g vsakih 6 ur, ni posledica varnostnega vidika.
English: Imipenem/cilastatin is not considered to be the best anti-staphylococcal agent, as other agents like semi-synthetic penicillins are generally considered to be more effective.
Slovenian: Imipenem/cilastatin ne velja za najboljše zdravilo proti stafilokokom, saj se druga zdravila, na primer polsintetični penicilini, na splošno štejejo za učinkovitejša.
English: The CHMP noted the proposed indication “prevention of certain post-operative infections in patients undergoing contaminated or potentially contaminated surgical procedures or where the occurrence of post-operative infection could be especially serious” and the data provided to support the indication, including several published studies evaluating imipenem or imipenem/cilastatin as prophylaxis antibiotic therapy to prevent post-surgical infections as a result of colorectal surgery, appendectomy, and endoscopic sclerotherapy.
Slovenian: CHMP je upošteval predlagano indikacijo „preprečevanje določenih pooperativnih okužb pri bolnikih, ki so bili izpostavljeni kontaminiranim ali potencialno kontaminiranim kirurškim posegom ali kadar bi bila lahko pooperativna okužba zelo huda “ in predstavljene podatke v podporo tej indikaciji, vključno z več objavljenimi študijami, v katerih so ocenjevali imipenem ali imipenem/cilastatin kot profilaktično antibiotično terapijo za preprečevanje pooperativnih okužb, ki so posledica kolorektalne operacije, apendektomije ali endoskopske skleroterapije.
English: The CHMP noted the proposed indication “gynaecological infections” but commented that the discussion of the available documentation focused primarily on intra- and post-partum infections.
Slovenian: CHMP je upošteval predlagano indikacijo „ginekološke okužbe“ in pripomnil, da je bil pregled razpoložljive dokumentacije osredotočen predvsem na okužbe med porodom in po njem.
English: The CHMP therefore deleted this indication.
Slovenian: Zato je CHMP to indikacijo izbrisal.
English: In conclusion, the CHMP was of the opinion that this indication was inadequately substantiated, and therefore deleted the indication.
Slovenian: CHMP je posledično menil, da ta indikacija ni ustrezno utemeljena in jo je zato izbrisal.
English: 4.1.1 Intra-abdominal infections
Slovenian: 4.1.1 Intraabdominalne okužbe
English: • the scope of the referral was the harmonisation of the summary of products characteristics, labelling and package leaflet
Slovenian: • obseg napotitve je bila uskladitev povzetka glavnih značilnosti zdravila, označevanja in navodila za uporabo;
English: Paediatric population ≥1 year of age
Slovenian: Pediatrična populacija, stara 1 leto ali več
English: In conclusion, based on the presented data, the CHMP considered the indication to be acceptable and adopted the following harmonised indication:
Slovenian: Na podlagi predstavljenih podatkov je CHMP posledično menil, da je indikacija sprejemljiva in sprejel naslednjo usklajeno indikacijo:
English: The CHMP noted the proposed indication “skin and soft tissue infections” (SSTI).
Slovenian: CHMP je upošteval predlagano indikacijo „okužbe kože in mehkih tkiv“.
English: Although data supporting this indication is limited, the CHMP considered the following harmonised indication to be acceptable:
Slovenian: Čeprav so dokazi v podporo tej indikaciji omejeni, je CHMP menil, da je navedena usklajena indikacija sprejemljiva:
English: The CHMP noted the proposed the indication “septicaemia” but remarked on the limited and old clinical trial data available.
Slovenian: CHMP je upošteval predlagano indikacijo „septikemija“ ter izpostavil, da so na voljo samo omejeni in stari podatki kliničnih preskušanj.
English: The issue of seizures in paediatric patients with systemic malignancies during therapy with imipenem/cilastatin was also discussed and the CHMP was reassured by the absence of evidence in support of an increased risk of seizures in this population.
Slovenian: Razpravljali so tudi o vprašanju napadov pri pediatričnih bolnikih s sistemski malignimi boleznimi med zdravljenjem z imipenemom/cilastatinom, odsotnost dokazov, ki bi potrdili povečano tveganje napadov pri tej populaciji, pa je CHMP dala dodatno zagotovilo.
English: The CHMP noted the proposed indication “bone and joint infections” but considered the data submitted to be insufficient.
Slovenian: CHMP je upošteval predlagano indikacijo „okužbe kosti in sklepov“, vendar je menil, da so predloženi podatki nezadostni.
English: 4.1.9 Prophylaxis
Slovenian: 4.1.9 Profilaksa
English: The CHMP was of the opinion that in light of the present clinical and PK/PD data, a standard dose of 500 mg every 6 hours or 1g every 8 hours can be accepted, provided that a recommendation is inserted in the SPC stating that for infections suspected or proven to be due to less susceptible organisms (e.g. P. aeruginosa) and for very severe infections (e.g. in neutropenic patients with a fever), the 1000 mg q.i.d should be used.
Slovenian: CHMP je menil, da je glede na zadnje klinične in farmakokinetične/farmakodinamične podatke običajni odmerek 500 mg vsakih 6 ur ali 1 g vsakih 8 ur sprejemljiv, če se v povzetek glavnih značilnosti zdravila vključi priporočilo, da se za okužbe, ki bi lahko bile ali so dokazano posledica manj občutljivih organizmov (na primer bakterije P. aeruginosa), in za zelo hude okužbe (na primer nevtropenični bolniki s povišano telesno temperaturo) uporablja odmerek 1 000 mg štirikrat na dan.
English: “Tienam may be used in the management of neutropenic patients with fever that is suspected to be due to a bacterial infection.”
Slovenian: „Zdravilo Tienam se lahko uporablja za zdravljenje nevtropeničnih bolnikov s povišano telesno temperaturo, ki je morda posledica bakterijske okužbe.
English: “complicated skin and soft-tissue infections”
Slovenian: „zapletene okužbe kože in mehkih tkiv“.
English: The presented data were very scarce and imipenem/cilastatin is not considered one of the most effective agents against staphylococci and methicillin-resistant staphylococci are known to be resistant to imipenem/cilastatin.
Slovenian: Predstavljeni podatki so bili zelo omejeni, imipenem/cilastatin pa se ne šteje kot eno najučinkovitejših zdravil proti stafilokokom, prav tako pa je znano, da so stafilokoki, odporni na meticilin, odporni tudi na imipenem/cilastatin.
English: 4.1.3 Gynaecological infections
Slovenian: 4.1.3 Ginekološke okužbe
English: The CHMP also assessed the limited data from literature sources and concluded that the claimed broad indication in the treatment of bone and joint infections could not be supported.
Slovenian: Ovrednotil je tudi omejene podatke iz literature in zaključil, da obširna indikacija pri zdravljenju okužb kosti in sklepov ni utemeljena.
English: Concomitant use of an appropriate anti-MRSA agent may be indicated when MRSA infections are suspected or proven to be involved in the approved indications.
Slovenian: Sočasna uporaba ustreznega zdravila proti bakteriji MRSA je lahko indicirana, kadar obstaja sum, da je okuženost z bakterijo MRSA vključena v odobrene indikacije ali pa je to dokazano.
English: Therefore, the CHMP did not consider imipenem/cilastatin to be an appropriate antibiotic for the empiric treatment of this life-threatening infection as the risk of selecting for MRSA is especially high.
Slovenian: CHMP je zato menil, da imipenem/cilastatin ni primeren antibiotik za empirično zdravljenje te smrtno nevarne okužbe, saj je tveganje selekcije bakterije MRSA še posebno visoko.
English: The CHMP was of the opinion that in light of the present clinical and PK/PD data, for paediatric patients ≥1 year of age, a standard dose of 15 or 25 mg/kg/dose administered every 6 hours is recommended.
Slovenian: CHMP je menil, da se glede na zadnje klinične in farmakokinetične/farmakodinamične podatke za pediatrične bolnike, stare eno leto ali več, priporoča običajni odmerek 15 ali 25 mg/kg/odmerek, ki se daje vsakih 6 ur.
English: The MAH discussed a number of specific indications, including community acquired pneumonia (CAP), cystic fibrosis, nosocomial pneumonia or ventilator associated pneumonia.
Slovenian: Imetnik dovoljenja za promet z zdravilom je obravnaval več specifičnih indikacij, vključno z zunajbolnišnično pridobljeno pljučnico, cistično fibrozo, bolnišnično pridobljeno pljučnico in z ventilatorji povezano pljučnico.
English: The CHMP noted the proposed indication “lower respiratory tract infections” but considered the indication to be non-specific and therefore no longer appropriate, according to the Guideline on Antibacterial agents.
Slovenian: CHMP je upošteval predlagano indikacijo „okužbe spodnjih dihal“ in menil, da je indikacija nespecifična in ob upoštevanju Smernice o protibakterijskih zdravilih ni več ustrezna.
English: “The antibacterial spectrum of imipenem/cilastatin should be taken into account especially in lifethreatening conditions before embarking on any empiric treatment.
Slovenian: „Pred pričetkom kakršnega koli empiričnega zdravljenja je treba upoštevati protibakterijski spekter imipenema/cilastatina, zlasti pri smrtno nevarnih stanjih.
English: The CHMP considered that the data provided by the MAH included sufficient evidence that imipenem/cilastatin is efficacious in most studies in treating complicated intra-abdominal infections including e.g., intra-abdominal abscesses, peritonitis, complicated appendicitis, gall bladder empyema.
Slovenian: CHMP je menil, da so v predloženih podatkih imetnika dovoljenja za promet z zdravilom zadostni dokazi, da je imipenem/cilastatin učinkovit v večini študij pri zdravljenju zapletenih intraabdominalnih okužb, med drugim intraabdominalnih abscesov, peritonitisa, kompliciranega apendicitisa, empiemov žolčnika.
English: The CHMP noted and assessed the available clinical trial and publication data showing that imipenem/cilastatin is effective and well tolerated in the treatment of “Complicated Skin and soft-tissue infections”.
Slovenian: CHMP je upošteval in ocenil razpoložljive podatke iz kliničnih preskušanj ter objavljene podatke o učinkovitosti in dobrem prenašanju imipenema/cilastatina pri zdravljenju „zapletenih okužb kože in mehkih tkiv“.
English: The MAH acknowledged that the spectrum of imipenem/cilatstatin does not cover Chlamydia trachomatis, and that there is insufficient evidence that Neisseria gonorrhoeae is a good target for therapy with this agent.
Slovenian: Imetnik dovoljenja za promet z zdravilom je potrdil, da spekter imipenema/cilastatina ne vključuje klamidije (Chlamydia trachomatis) ter da ni zadostnih dokazov, ki bi potrdili, da je to zdravilo primerno za zdravljenje gonoreje (Neisseria gonorrhoeae).
English: 4.1.2 Lower respiratory tract infections
Slovenian: 4.1.2 Okužbe spodnjih dihal
English: In addition, the term “genitourinary tract infections” was considered outdated.
Slovenian: Poleg tega so menili, da je izraz „okužbe sečil in spolovil“ zastarel.
English: The CHMP noted the proposed indication “genitourinary infections” but stated that imipenem/cilastatin should be used only in severe bacterial infections suspected or due to pathogens resistant to other beta-lactams and susceptible to imipenem/cilastatin.
Slovenian: CHMP je upošteval predlagano indikacijo „okužbe sečil in spolovil“, vendar je menil, da se lahko imipenem/cilastatin uporablja le pri hudih bakterijskih okužbah, ki bi lahko bile ali so posledica patogenov, odpornih na druge betalaktame in občutljivih za imipenem/cilastatin.
English: Furthermore imipenem/cilastatin has no activity against MRSA and is therefore not considered to be an appropriate antibiotic for the empiric treatment of SSTIs caused by staphylococci since the risk of selecting for MRSA is quite high.
Slovenian: Imipenem/cilastatin prav tako ne deluje proti bakteriji MRSA in se tako ne šteje za ustrezni antibiotik za empirično zdravljenje okužb kože in mehkih tkiv, ki jih povzročajo stafilokoki, saj je tveganje selekcije bakterije MRSA precej visoko.