[Prospective comparative observational study on the antibiotic treatment of secondary peritonitis in Germany -- efficacy and cost analysis].
OBJECTIVE
Cephalosporins and broad-spectrum penicillins in combination with metronidazole are suitable for treatment of secondary peritonitis. The aim of this study was to compare the clinical and bacteriological efficacy, length of hospital stay (LOS), treatment costs of ceftriaxone (CRO) in combination with metronidazole vs standard regimens (SR) 1 and 2.


METHODS
Patient data were subjected to matched-pairs analysis according to four different categories of the Mannheim peritonitis index. RESULTS. From January 1998 to March 2000, a total of 365 patients from 59 surgical wards in German hospitals were included. Clinical efficacy was 90.2% vs 70.4% ( P=0.004) for CRO/SR 1 and 78.3% vs 82.6% for CRO/SR 2. Bacteriological efficacy was comparable. Antibiotic treatment costs were 593/539 Euros for CRO/SR 1 and 466/750 Euros for CRO/SR 2, i.e., costs for CRO were 37.9% lower than with SR 2.


CONCLUSIONS
Based on clinical, bacteriological, and pharmacoeconomic results, ceftriaxone in combination with metronidazole can be regarded as a first-line antimicrobial treatment of secondary peritonitis.
Mittelkötter
U
U
Klinik für Allgemeine Chirurgie, Universität Münster. Ulrich.Mittelkoetter@mednet.uni-muenster.de
Endter
F
F
Reith
H B
HB
Thielemann
H
H
Schmitz
R
R
Ihle
P
P
Kullmann
K-H
KH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D016527:Drug Costs; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D008875:Middle Aged; D010538:Peritonitis / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000209:etiology; D011446:Prospective Studies; D013997:Time Factors
D000900:Anti-Bacterial Agents; D008795:Metronidazole; D002443:Ceftriaxone