title: Treatment of polymicrobial infections: post hoc analysis of three trials comparing ertapenem and piperacillin-tazobactam.
abstract: The efficacy of ertapenem 1 g once a day for the treatment of polymicrobial complicated intra-abdominal, complicated skin/skin-structure and acute pelvic infections was compared with piperacillin-tazobactam 3.375 g every 6 h in a post hoc analysis of data from three large randomized double-blind trials. Of the 1,558 treated patients in the three trials, no pathogen was identified in 345 (22.1%), 423 (27.2%) had a monomicrobial infection and 790 (50.7%) had a polymicrobial infection. At the test-of-cure assessment, there were no significant differences in outcome between the two treatment groups for any of the three infections. Cure rates (clinical and microbiological for intra-abdominal infection, clinical for skin/skin-structure and pelvic infections) in microbiologically evaluable patients for ertapenem and piperacillin-tazobactam, respectively, were 85.6% (154/180 evaluable patients) and 82.5% (127/154) for polymicrobial intra-abdominal infection, 80.3% (53/66) and 78.7% (48/61) for polymicrobial skin/skin-structure infection, and 95.7% (88/92) and 92.6% (88/95) for polymicrobial pelvic infection. Respective cure rates for all evaluable patients in the original trials were: 83.6% and 80.4% for intra-abdominal, 83.9% and 85.3% for skin/skin-structure, and 93.9% and 91.5% for pelvic infections. These data show that in the three trials, ertapenem 1 g once a day was highly effective for the treatment of polymicrobial infections and as effective as piperacillin-tazobactam 3.375 g every 6 h.
authors.affiliation: Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Solomkin
authors.forename: Hedy
authors.initials: H
authors.lastname: Teppler
authors.forename: Donald R
authors.initials: DR
authors.lastname: Graham
authors.forename: Richard M
authors.initials: RM
authors.lastname: Gesser
authors.forename: Anne R
authors.initials: AR
authors.lastname: Meibohm
authors.forename: Subir
authors.initials: S
authors.lastname: Roy
authors.forename: Gail L
authors.initials: GL
authors.lastname: Woods
mesh_terms: D000005:Abdomen; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001420:Bacteria, Aerobic / Q000302:isolation & purification; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D001424:Bacterial Infections / Q000150:complications* / Q000188:drug therapy* / Q000382:microbiology; D004311:Double-Blind Method; D000077727:Ertapenem; D005260:Female; D006801:Humans; D007769:Lactams / Q000627:therapeutic use*; D008297:Male; D034161:Pelvic Infection / Q000188:drug therapy* / Q000382:microbiology; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use*; D010878:Piperacillin / Q000627:therapeutic use*; D000077725:Piperacillin, Tazobactam Drug Combination; D011446:Prospective Studies; D017192:Skin Diseases, Bacterial / Q000188:drug therapy / Q000382:microbiology; D016896:Treatment Outcome; D047090:beta-Lactams
chemical_list: D000900:Anti-Bacterial Agents; D007769:Lactams; D047090:beta-Lactams; D000077725:Piperacillin, Tazobactam Drug Combination; D010397:Penicillanic Acid; D000077727:Ertapenem; D010878:Piperacillin