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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Comparison of sequential intravenous/oral ciprofloxacin plus metronidazole with intravenous ceftriaxone plus metronidazole for treatment of complicated intra-abdominal infections
Surgical Infections, Volume 7, No. 4, Year 2006
Notification
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Description
Background and Purpose: Intra-abdominal infections are a substantial clinical problem and an important cause of morbidity and death in the hospital. Optimal treatment requires both source control and antibiotic therapy. Sequential intravenous (IV) to oral therapy may improve patient convenience and reduce total health care costs. In this randomized, double-blind trial, the efficacy of sequential IV-to-oral ciprofloxacin plus metronida/ole was compared with ceftriaxone plus metronidazole in adult patients with complicated intra-abdominal infections. Methods: The trial enrolled 531 patients, who began with IV therapy. Patients who improved clinically were switched to oral therapy on day three or later. The clinical and bacteriological responses four to six weeks after the end of therapy and the safety of the two regimens were assessed. To maintain blinding, the patients received placebo IV in the ciprofloxacin group or placebo orally in the ceftriaxone group. A total of 475 patients (235 ciprofloxacin plus metronidazole, 240 ceftriaxone plus metronidazole) were valid for evaluation of efficacy. All patients were included in the safety analysis. Results: Of the patients valid for efficacy, 78% of the ciprofloxacin plus metronidazole group and 81% of the ceftriaxone plus metronidazole group were eligible for a switch to oral therapy. The clinical success rates were 98.9% and 96.9%, respectively, which were statistically equivalent. The clinical success rates for all patients, including those on continuous IV therapy, were 90.6% and 87.9%. Source control was achieved in more than 90% of the patients. The bacteriological eradication rates were similar in the two groups. Bacterial complications (e.g., surgical site infections, abscesses) were encountered more often in the ceftriaxone plus metronidazole group. Conclusions: Sequential ciprofloxacin plus metronidazole IV-to-oral therapy was statistically equivalent to ceftriaxone plus metronidazole. The switch to oral therapy with ciprofloxacin plus metronidazole was as effective and safe as continued IV therapy in patients able to tolerate enterai feeding. © Mary Ann Liebert, Inc.
Authors & Co-Authors
Wacha, Hannes
Germany, Frankfurt am Main
Goethe-universität Frankfurt am Main
Warren, Brian Leigh
South Africa, Tygerberg
Tygerberg Hospital
Bassaris, Harry
Greece, Rio
University General Hospital of Patras
Nikolaidis, Paul
Greece, Thessaloniki
University General Hospital of Thessaloniki Ahepa
Vestweber, Karl
Germany, Leverkusen
Klinikum-lev .de
Pichlmayr, Rudolf
Germany, Hannover
Gottfried Wilhelm Leibniz Universität Hannover
Engemann, Rainer
Germany, Aschaffenburg
Onkologie Aschaffenburg
Buchholz, Wolfgang
Germany, Berlin
Hospital Berlin-kaulsdorf
Buhr, Heinz
Germany, Berlin
Charité – Universitätsmedizin Berlin
Von Feldmann, Frank
Germany, Berlin
St. Joseph Hospital
Hohenberger, Werner
Germany, Erlangen
Friedrich-alexander-universität Erlangen-nürnberg
Meister, Richard
Germany, Bamberg
Sozialstiftung Bamberg
Cugnenc, Jacques
France, Paris
Hopital Laennec
Huten, Noël
France, Tours
Hopital Trousseau
Chevallier, Jean Marc
France, Paris
Hopital Boucicaut
Létoublon, Christian
France, Grenoble
Centre Hospitalier Universitaire de Grenoble
Domergue, Jacques
France, Montpellier
Hôpital Saint Eloi
Brimas, Gintautas
Lithuania, Vilnius
Vilniaus Universitetas
Pavalkis, Daninius
Lithuania, Kaunas
Kaunas University of Medicine
Drews, Michael
Poland, Poznan
Provincial Hospital in Poznan
Búchler, Markus Wolfgang
Switzerland, Bern
University Hospital Bern
Igra, Yardena
Israel, Tel Aviv-yafo
Tel Aviv Sourasky Medical Center
Kitzes, Ruth
Israel, Haifa
Carmel Medical Center
Lang, Ruth
Israel, Kfar Saba
Meir Medical Center
Solomon, Michael
Australia, Sydney
Royal Prince Alfred Hospital
Smith, Ross
Australia, Penrith
Nepean Hospital
Raz, Raul
Israel, Afula
Emek Medical Center
Pfeffermann, Reuven
Israel, Rehovot
Kaplan Medical Center
Dan, Michael
Israel, Holon
Edith Wolfson Medical Center Israel
Senninger, Norbert
Germany, Heidelberg
Universitätsklinikum Heidelberg
Jauch, Karl Walter
Germany, Regensburg
Universität Regensburg
Gebhardt, Christoph
Germany, Nurnberg
Nuremberg Hospital
Statistics
Citations: 32
Authors: 32
Affiliations: 32
Identifiers
Doi:
10.1089/sur.2006.7.341
ISSN:
10962964
Research Areas
Disability
Health System And Policy