[Treatment and surgery of abdominal septic states: comparison of two antibiotic therapies].

Pharmatherapeutica Pub Date : 1989-01-01
D Levi, P Lemba, K Amery
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Abstract

A prospective, randomized controlled study was carried out in 104 patients to compare clavulanate-potentiated amoxycillin ('Augmentin') with a combination of cephalosporins (cefazoline and cefadroxil) supplemented with metronidazole in the treatment of abdominal septic states, suspected or proven after surgical intervention. Patients on 'Augmentin' received 1.2 g (1 g amoxycillin plus 200 mg clavulanic acid) intravenously 3-times daily for a mean of 6.6 days, then 375 mg (250 amoxycillin plus 125 mg clavulanic acid) orally for a further 6.4 days. Patients on the standard therapy received 1 g cefazoline intravenously 4-times daily plus 500 mg metronidazole intravenously 3-times daily for 7 days, then 500 mg cefadroxil orally 4-times daily for a mean of 6.6 days. Evaluation of the patients' condition was undertaken after 24 hours, 3 days and 7 days. The results showed a significantly better response to treatment in the 'Augmentin' group, as judged by the amelioration of clinical symptoms, bacteriological findings, and tolerance. All the patients treated with 'Augmentin' showed an excellent or satisfactory overall response at Day 7 compared with 76% of those receiving the standard therapy.

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[腹部脓毒症的治疗与手术:两种抗生素治疗的比较]。
一项前瞻性、随机对照研究在104例患者中进行,比较克拉维酸增强阿莫西林(Augmentin)与头孢菌素(头孢唑啉和头孢羟肟)联合补充甲硝唑治疗腹部脓毒症的疗效,怀疑或证实手术干预后。服用Augmentin的患者每天静脉注射3次1.2 g (1 g阿莫西林加200 mg克拉维酸),平均6.6天,然后口服375 mg(250阿莫西林加125 mg克拉维酸),再持续6.4天。标准治疗组患者给予头孢唑啉1 g静脉滴注,每日4次,加甲硝唑500 mg静脉滴注,每日3次,连用7天,再给予头孢地诺酯500 mg口服,每日4次,平均连用6.6天。分别于24小时、3天和7天后对患者进行病情评估。结果显示,根据临床症状、细菌学结果和耐受性的改善,“Augmentin”组对治疗的反应明显更好。所有接受Augmentin治疗的患者在第7天显示出良好或满意的总体反应,而接受标准治疗的患者中有76%。
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