Management of severe intra-abdominal sepsis: Single agent antibiotic therapy with cefotetan versus combination therapy with ampicillin, gentamicin and metronidazole

Author:

Huizinga W K J1,Baker L W1,Kadwa H1,van den Ende J2,Francis A J1,Francis G M1

Affiliation:

1. Department of Surgery, Natal University Medical School, Durban, South Africa

2. Department of Microbiology, Natal University Medical School, Durban, South Africa

Abstract

Abstract In a prospective, randomized trial involving 100 patients with severe intra-abdominal sepsis, the value of single agent antibiotic therapy with cefotetan was compared with that of combination therapy of ampicillin, gentamicin and metronidazole (AGM). All patients underwent exploratory laparotomy. The mortality rate was 3 per cent, all deaths occurring within 48 h of operation. Two-thirds of patients were considered severely ill on admission, and one-third were moderately ill. Six patients had positive blood cultures on entry into the study. The mean age was 31 years and concurrent disease was present in 14 percent of the patients. A satisfactory response was achieved in 82 per cent of patients receiving cefotetan and in 65 per cent of those receiving AGM, whereas the response was unsatisfactory in 18 per cent of cefotetan patients and 35 per cent of those receiving AGM (P = 0.075 n.s.). Significant changes in laboratory values during the study occurred in 51 per cent of patients, and 7 per cent required vitamin K administration for hypoprothrombinaemia. The results of this study suggest that antibiotic therapy with single agent cefotetan is as safe and effective as a combination of ampicillin, gentamicin and metronidazole in patients with severe intra-abdominal sepsis requiring operative management.

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference33 articles.

1. Prospective, randomised comparison of metronidazole and clindamycin, each with gentamicin, for the treatment of serious intra-abdominal infection;Canadian Metronidazole-Clindamycin Study Group;Surgery,1983

2. Prospective, randomised comparative study of clindamycin, chloramphenicol and ticarcillin, each in combination with gentamicin, in therapy for intra-abdominal and female genital tract sepsis;Harding;Infect Dis,1980

3. Clinical comparison of antibiotic combinations in the treatment of peritonitis and related mixed aerobic-anaerobic surgical sepsis;Stone;World J Surg,1980

4. A prospective randomised controlled trial of cefoxitin versus clindamycin-aminoglycoside in mixed anaerobic-aerobic infections;Drusano;Surg Gynecol Obstet,1982

5. Double-blind comparison of metronidazole plus gentamicin and clindamycin plus gentamicin in intra-abdominal infection;Kirkpatrick;Surgery,1982

Cited by 19 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3