Intra-abdominal infections: review of the bacteriology, antimicrobial susceptibility and the role of ertapenem in their therapy.
Complicated intra-abdominal infections require a combination of surgery/drainage and antimicrobial therapy that is active against both the aerobic and the anaerobic bacteria that comprise the intestinal flora. Ertapenem, a parenteral carbapenem, is highly resistant to a wide variety of beta-lactamase enzymes, and has a broad spectrum of activity against bacteria associated with community-acquired infections including those of complicated intra-abdominal conditions. This article reviews the bacteriology of complicated intra-abdominal infections, their antimicrobial susceptibility, especially to anaerobes, the utility of animal models in these mixed infections, and the supportive clinical trials and in vitro susceptibility data that show ertapenem to be generally well tolerated and as effective as either piperacillin-tazobactam or ceftriaxone plus metronidazole in the therapy of complicated intra-abdominal infections.
Goldstein
Ellie J C
EJ
R M Alden Research Laboratory, Santa Monica, CA 90404, USA. EJCGMD@aol.com
Snydman
David R
DR
D000005:Abdomen; D018784:Abdominal Abscess / Q000188:drug therapy* / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001421:Bacteria, Anaerobic / Q000187:drug effects*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D002986:Clinical Trials as Topic; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D000077727:Ertapenem; D005260:Female; D006801:Humans; D007769:Lactams / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D051381:Rats; D047090:beta-Lactams
D000900:Anti-Bacterial Agents; D007769:Lactams; D047090:beta-Lactams; D000077727:Ertapenem