title: A comparison of imipenem/cilastatin with the combination of cefuroxime and metronidazole in the treatment of intra-abdominal infections.
abstract: 515 patients with intra-abdominal infection participated in an open randomized comparative multicenter trial in order to compare the efficacy, safety, and tolerance of imipenem/cilastatin with cefuroxime/metronidazole. 258 patients (mean age 56 years) received imipenem/cilastatin 1.5-2.0 g/day, and 257 patients (mean age 54 years) received cefuroxime 3.0-4.5 g/day plus metronidazole 1.0-1.5 g/day for at least 3 days. 130/161 evaluable patients (80.8%) receiving imipenem/cilastatin and 124/145 evaluable patients (85.5%) receiving cefuroxime/metronidazole were clinically cured. The microbiological response was favorable in 86.9% in the imipenem/cilastatin group and in 90.8% in the cefuroxime/metronidazole group. The two treatment groups were similar with respect to median time to defervescence which was 4 days. The median duration of treatment was 6 days and the median time to discharge from hospital was 9 days in both groups. Drug-related adverse reactions were observed in 14 patients receiving iminpenem/cilastatin and in 8 patients receiving cefuroxime/metronidazole. 19 patients in the imipenen/cilastatin group and 12 patients in the cefuroxime/metronidazole group died. No correlation was found between the deaths and the study drugs. The present study shows that intra-abdominal infections can be treated successfully with imipenem/cilastatin as well as with cefuroxime/metronidazole.
authors.affiliation: Department of Surgery, Ostra Hospital, University of Göteborg, Sweden.
authors.forename: M H
authors.initials: MH
authors.lastname: Angerås
authors.forename: N
authors.initials: N
authors.lastname: Darle
authors.forename: K
authors.initials: K
authors.lastname: Hamnström
authors.forename: M
authors.initials: M
authors.lastname: Ekelund
authors.forename: L
authors.initials: L
authors.lastname: Engström
authors.forename: J
authors.initials: J
authors.lastname: Takala
authors.forename: A
authors.initials: A
authors.lastname: Viste
authors.forename: J B
authors.initials: JB
authors.lastname: Holme
mesh_terms: D000005:Abdomen / Q000382:microbiology*; D018784:Abdominal Abscess / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000188:drug therapy*; D002444:Cefuroxime / Q000009:adverse effects / Q000627:therapeutic use*; D015377:Cilastatin / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D015378:Imipenem / Q000009:adverse effects / Q000627:therapeutic use*; D008795:Metronidazole / Q000009:adverse effects / Q000627:therapeutic use*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D008795:Metronidazole; D015377:Cilastatin; D015378:Imipenem; D002444:Cefuroxime