Sulbactam/ampicillin for treatment of polymicrobial pelvic infections.
The increasing number of beta-lactam antibiotic-resistant bacteria observed in many strains of aerobic and anaerobic Gram-positive and Gram-negative bacteria, including Bacteroides species, has been well documented. Semisynthetic synthesis of penicillins and cephalosporins with increased resistance to beta-lactamase enzyme hydrolysis has not solved the problem. An alternative to therapy with newer agents is combination of an irreversible, suicide-type, beta-lactamase enzyme inhibitor such as sulbactam with a beta-lactam antibiotic such as ampicillin. Women with a variety of acute polymicrobial pelvic infections have been treated with the above combination, metronidazole or clindamycin combined with aminoglycoside, or cefoxitin in prospective trials. The clinical efficacy of 92.4%, in vitro bacteriological efficacy of 96.6%, and safety of sulbactam/ampicillin were comparable to that observed in women given comparative therapy. Penetration of pelvic tissues by sulbactam and ampicillin was excellent. Sulbactam/ampicillin is a viable alternative for the treatment of women with acute pelvic infections.
D000667:Ampicillin / Q000009:adverse effects / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000188:drug therapy* / Q000382:microbiology; D010397:Penicillanic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D010403:Penicillin Resistance; D011446:Prospective Studies; D011897:Random Allocation; D013407:Sulbactam; D065093:beta-Lactamase Inhibitors
D000900:Anti-Bacterial Agents; D065093:beta-Lactamase Inhibitors; D000667:Ampicillin; D010397:Penicillanic Acid; D013407:Sulbactam