Meropenem monotherapy versus cefotaxime plus metronidazole combination treatment for serious intra-abdominal infections.
In an open, randomised, multicentre trial, the efficacy and tolerability of empirical meropenem monotherapy (1 g intravenously every 8 hours) and cefotaxime (2 g every 8 hours) plus metronidazole (0.5 g intravenously every 8 hours) for 5 to 10 days was compared in 94 patients with serious intra-abdominal infection who required surgery. Eighty-three patients had an evaluable clinical response. Significantly more patients in the meropenem group had a satisfactory clinical response at the end of treatment (41/43 [95.3%] vs 30/40 [75.0%]; p = 0.008). The bacteriological response was also higher in the meropenem group (31/33 vs 26/32). In the bacteriologically evaluable population, a satisfactory clinical response was observed in 31/33 of those who received meropenem compared to 24/32 of the cefotaxime/metronidazole recipients (p = 0.03). Empirical meropenem monotherapy should prove a useful alternative to the currently standard combination treatment for serious intraabdominal infections.
Kempf
P
P
Chirurgische Klinik, Stadtkrankenhaus Rüsselsheim, Germany.
Bauernfeind
A
A
Müller
A
A
Blum
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000994:Antitrichomonal Agents / Q000627:therapeutic use*; D002439:Cefotaxime / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007239:Infections / Q000188:drug therapy*; D007262:Infusions, Intravenous; D008297:Male; D000077731:Meropenem; D008795:Metronidazole / Q000627:therapeutic use*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010538:Peritonitis / Q000188:drug therapy*; D012720:Severity of Illness Index; D013845:Thienamycins / Q000627:therapeutic use*; D016896:Treatment Outcome
D000994:Antitrichomonal Agents; D002511:Cephalosporins; D013845:Thienamycins; D008795:Metronidazole; D000077731:Meropenem; D002439:Cefotaxime