Antibiotic management of surgically treated gangrenous or perforated appendicitis. Comparison of gentamicin and clindamycin versus cefamandole versus cefoperazone.
A study of 130 adult patients with surgically treated gangrenous or perforated appendicitis was undertaken to evaluate the efficacy of three antibiotic regimens. Forty-eight patients received cefamandole, 40 were given the combination of clindamycin and gentamicin, and 42 were treated with cefoperazone. Side effects from these antibiotics were infrequent and mild. When all cases were compared for infectious failure, clindamycin-gentamicin showed a clear advantage over cefamandole. Because of the heterogeneity of the total study population, patients with perforation and peritonitis were compared separately. This analysis confirmed the advantage of clindamycin-gentamicin over cefamandole. In addition, it appears that clindamycin-gentamicin is more efficacious than cefoperazone.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001064:Appendicitis / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D002435:Cefamandole / Q000627:therapeutic use*; D002438:Cefoperazone; D002511:Cephalosporins / Q000627:therapeutic use*; D002981:Clindamycin / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005734:Gangrene; D005839:Gentamicins / Q000627:therapeutic use*; D006801:Humans; D007416:Intestinal Perforation / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000188:drug therapy; D011897:Random Allocation
D002511:Cephalosporins; D005839:Gentamicins; D002981:Clindamycin; D002435:Cefamandole; D002438:Cefoperazone