Randomized comparative study of ampicillin/sulbactam vs. ceftriaxone for treatment of soft tissue and skeletal infections in children.
In a prospective study 105 children hospitalized with soft tissue infection, 11 children with suppurative arthritis and 9 children with osteomyelitis were treated with either parenterally administered ampicillin/sulbactam or ceftriaxone. Treatment was randomized using a computer-generated table in a 2:1 fashion: 84 patients received ampicillin/sulbactam and 41 patients received ceftriaxone. Organisms isolated from wound site or blood cultures included Staphylococcus aureus (33), Streptococcus pyogenes (19), Haemophilus influenzae (9) including 4 beta-lactamase-positive organisms, Streptococcus pneumoniae (5), Neisseria gonorrhoeae (3) and 9 other organisms. Clinical and bacteriologic response was satisfactory in 100% of the ampicillin/sulbactam-treated patients and in 93% of the ceftriaxone-treated patients. Two patients with S. aureus infections treated with ceftriaxone had a delayed response and required change in therapy to parenterally administered oxacillin. Ampicillin/sulbactam represents a potentially useful single agent for the treatment of cellulitis and bone or joint infections in pediatric patients.
Kulhanjian
J
J
Division of Infectious Diseases, Children's Hospital Oakland, CA 94609.
Dunphy
M G
MG
Hamstra
S
S
Levernier
K
K
Rankin
M
M
Petru
A
A
Azimi
P
P
D000151:Acinetobacter Infections / Q000188:drug therapy; D000293:Adolescent; D000667:Ampicillin / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000188:drug therapy*; D002443:Ceftriaxone / Q000627:therapeutic use*; D002481:Cellulitis / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004927:Escherichia coli Infections / Q000188:drug therapy; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy; D006192:Haemophilus Infections / Q000188:drug therapy; D006801:Humans; D007223:Infant; D008297:Male; D010019:Osteomyelitis / Q000188:drug therapy*; D011446:Prospective Studies; D011897:Random Allocation; D013203:Staphylococcal Infections / Q000188:drug therapy; D013290:Streptococcal Infections / Q000188:drug therapy; D013407:Sulbactam / Q000627:therapeutic use*
C035444:sultamicillin; D002443:Ceftriaxone; D000667:Ampicillin; D013407:Sulbactam