en
Scientific article
Open access
English

A randomized prospective study of cefepime plus metronidazole with imipenem-cilastatin in the treatment of intra-abdominal infections

Published inInfection, vol. 35, no. 3, p. 161-166
Collection
  • Open Access - Licence nationale Springer
Publication date2007
Abstract

BACKGROUND: Presumptive antimicrobial therapy is an important aspect of the management of intra-abdominal infections. Together with surgery, antimicrobial combinations are still widely used to achieve the required spectrum of activity. The aim of this study was to evaluate the efficacy of parenteral cefepime + metronidazole vs imipenem-cilastatin for the treatment of intra-abdominal infections in adult patients. METHODS: Patients with a clinically confirmed diagnosis of intra-abdominal infection were randomized to one of two treatment regimens: cefepime 2 g iv/12 h plus metronidazole 500 mg/8 h or imipenem-cilastatin 500 mg iv/6 h. The primary measure of clinical response was the decline of pre-treatment signs and symptoms of infection. The duration of follow-up was 30 days. Treatment failure was defined as either a lack of improvement or a worsening of pre-treatment signs and symptoms of infection. Surgical management of the infection was determined by the surgeon-in-charge. RESULTS: Of the 122 intended-to-treat patients included in the study, 60 patients (33 men) were randomized to cefepime + metronidazole and 61 (27 men) to imipenem-cilastatin. Cefepime + metronidazole treatment was successful in 52 (87%) patients and imipenem-cilastatin in 44 (72%) patients (p = 0.004). Microbiological eradication was established in similar proportions in both groups (cefepime + metronidazole, 43; imipenem-cilastatin, 38). CONCLUSION: Further studies are warranted to confirm the better results with the cefepime + metronidazole regimen for the treatment of intra-abdominal infections.

Keywords
  • Apache
  • Abdominal Cavity/microbiology
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents/ therapeutic use
  • Bacterial Infections/ drug therapy
  • Cephalosporins/ therapeutic use
  • Cilastatin/therapeutic use
  • Drug Combinations
  • Drug Therapy, Combination
  • Female
  • Gastrointestinal Diseases/ drug therapy/microbiology
  • Hospitals, University
  • Humans
  • Imipenem/therapeutic use
  • Male
  • Metronidazole/ therapeutic use
  • Middle Aged
Citation (ISO format)
GARBINO, Jorge et al. A randomized prospective study of cefepime plus metronidazole with imipenem-cilastatin in the treatment of intra-abdominal infections. In: Infection, 2007, vol. 35, n° 3, p. 161–166. doi: 10.1007/s15010-007-6237-2
Main files (1)
Article (Published version)
accessLevelPublic
Identifiers
ISSN of the journal0300-8126
574views
212downloads

Technical informations

Creation06/21/2010 10:24:21 AM
First validation06/21/2010 10:24:21 AM
Update time03/14/2023 3:43:46 PM
Status update03/14/2023 3:43:46 PM
Last indexation01/15/2024 8:11:11 PM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack