Author:
Freeman Collin D.,Nightingale Charles H.,Nicolau David P.,Belliveau Paul P.,Tessier Pamela R.,Fu Qiang,Xuan Da‐Wei,Quintiliani Richard
Abstract
Eighteen volunteers received ceftizoxime 1 g plus metronidazole 500 mg intravenously every 12 hours, cefoxitin 2 g intravenously every 6 hours, and ampicillin‐sulbactam 3 g every 6 hours in a triple‐crossover, open‐label study to compare serum bactericidal titers (SBTs) against two strains of Escherichia coli and Bacteroides fragilis. Serum was analyzed for drug concentration and bactericidal activity. Ceftizoxime‐metronidazole exhibited a significantly greater (p<0.05) area under the bactericidal curve and percentage of the dosing interval with SBTs of 1:2 or above against E. coli than cefoxitin or ampicillin‐sulbactam. The respective values were equal to those of ampicillin‐sulbactam for one strain of B. fragilis (both greater than cefoxitin) and greater than cefoxitin and ampicillin‐sulbactam for the other strain. A 1‐g dose of ceftizoxime given with metronidazole 500 mg every 12 hours should be an effective alternative to standard antibiotic treatment of mixed aerobic‐anaerobic bacterial infections.