title: Randomized comparative trial with ampicillin/sulbactam versus cefamandole in the therapy of community acquired pneumonia.
abstract: In a randomized prospective study ampicillin/sulbactam and cefamandole were compared in the therapy of patients hospitalized with community acquired pneumonia. Patients receiving ampicillin/sulbactam (n = 37) and cefamandole (n = 38) were similar with respect to age (mean age 70 vs. 76 years respectively), clinical characteristics, severity of illness and underlying disease. Pathogens isolated from patients in the cefamandole and ampicillin/sulbactam group, respectively, were Streptococcus pneumoniae (7 vs. 7 patients), Haemophilus parainfluenzae (7 vs. 6 patients), Haemophilus influenzae (5 vs. 5 patients), Staphylococcus aureus (5 vs. 4 patients), Escherichia coli (4 vs. 4 patients), Klebsiella pneumoniae (3 vs. 3 patients), Enterobacter spp. (2 vs. 3 patients), Moraxella catarrhalis (1 vs. 2 patients), and organisms of the oral flora (4 vs. 3 patients). The rate of resistance to penicillin was 80%, to clindamycin 76%, to erythromycin 45%, to ampicillin 43%, and to cefazolin 18%. Overall successful treatment rates of 81% for cefamandole and 97% for ampicillin/sulbactam (p = 0.05) were observed. Both cefamandole and ampicillin/sulbactam were shown to be effective agents for therapy of community acquired pneumonia; however ampicillin/sulbactam demonstrated superior overall clinical efficacy.
authors.affiliation: Department of Medicine, William Beaumont Hospital, Royal Oak, Michigan 48073.
authors.forename: D
authors.initials: D
authors.lastname: Williams
authors.forename: M
authors.initials: M
authors.lastname: Perri
authors.forename: M J
authors.initials: MJ
authors.lastname: Zervos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000009:adverse effects / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D002435:Cefamandole / Q000009:adverse effects / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy* / Q000382:microbiology; D011446:Prospective Studies; D013183:Sputum / Q000382:microbiology; D013407:Sulbactam / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D002435:Cefamandole; C035444:sultamicillin; D000667:Ampicillin; D013407:Sulbactam