Comparison of cefoperazone plus sulbactam with clindamycin plus gentamicin as treatment for intra-abdominal infections

Richard N. Greenberg, Paul Cayavee, Linda S. Danko, Karen Bowen, Robert Montazemi, Paul A. Kearney, Steven B. Johnson, William E. Strodel

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

This study compared the safety and efficacy of cefoperazone plus sulbactam with that of clindamycin plus gentamicin in the treatment of intra-abdominal infection. Seventy-six patients were included in the analysis of an open, randomized, comparative, single-site trial. Forty-seven patients received cefoperazone-sulbactam, and 29 patients received clindamycin plus gentamicin. Thirty-three patients (70%) who received cefoperazone-sulbactam and 15 patients (52%) who received clindamycin plus gentamicin were cured of infection, did not suffer a relapse within one month after the end of treatment, and did not receive any other antibiotics during the follow-up period (P = 0.17). In patients treated with cefoperazone-sulbactam there were four cases of superinfection, one patient had a prolonged prothrombin time, six patients had a poor response, two patients received antibiotics during follow-up, and one patient died during follow-up because of cancer. Treatment with clindamycin plus gentamicin was associated with five cases of superinfection, four patients had a poor response, four patients had a drug reaction, and one patient required antibiotics in the follow-up period. Serum levels of cefoperazone-sulbactam measured at one and three hours after dosing were consistent with earlier findings in normal volunteers. Two hundred and one pathogens were isolated, and 17 of 122 aerobic isolates (14%) were resistant to cefoperazone-sulbactam, and 17 of 122 (14%) were resistant to both clindamycin and gentamicin. Eleven of 79 (14%) anaerobic isolates were resistant to cefoperazone, none was resistant to cefoperazone-sulbactam, and 10 of 79(13%) were resistant to clindamycin. The results of this study show that cefoperazone-sulbactam is an effective and safe alternative to clindamycin plus gentamicin in the treatment of intra-abdominal infections.

Original languageEnglish
Pages (from-to)391-401
Number of pages11
JournalJournal of Antimicrobial Chemotherapy
Volume34
Issue number3
DOIs
StatePublished - Sep 1994

Bibliographical note

Funding Information:
This study was supported by a grant from Pfizer Pharmaceuticals, New York, NY, USA. The laboratory assistance of David Meade is appreciated. Jenny Cox, RN, Saeed Shariaty, LPN, Rebecca Gelholt, RN, Julie Moore, RN, Vernon Hackworth, Flo Witte, and Harlan Bozarth, Jr., contributed greatly to this study.

ASJC Scopus subject areas

  • Pharmacology
  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

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