Comparison of imipenem/cilastatin with the combination of aztreonam and clindamycin in the treatment of intra-abdominal infections

Groot, Hans G.W. de; Hustinx, P. A.; Lampe, A. S.; Oosterwijk, W. M.

doi:10.1093/jac/32.3.491

Cited by 26 publications

(14 citation statements)

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“…Aztreonam plus clindamycin was listed previously as an acceptable regimen for the treatment of patients with intra-abdominal infections [1]. Three additional prospective trials, including 177 clinically evaluable patients treated with this regimen, have been published since 1990 [51,57,96]. Aztreonam plus clindamycin was compared to an aminoglycoside plus clindamycin in two studies [51,57] and to imipenem/cilastatin in one [96].…”

Section: Penicillin/beta-lactamase Inhibitor Combinationsmentioning

confidence: 99%

The Surgical Infection Society Guidelines on Antimicrobial Therapy for Intra-Abdominal Infections: Evidence for the Recommendations

Mazuski

Sawyer

Nathens

et al. 2002

Surgical Infections

114

130

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Revised guidelines for the use of antimicrobial therapy in patients with intra-abdominal infections were recently developed by the Therapeutic Agents Committee of the Surgical Infection Society (Mazuski et al., Surg Infect 2002;3:161-173). These were based, insofar as possible, on evidence published over the past decade. The objective of this document is to describe the process by which the Committee identified and reviewed the published literature utilized to develop the recommendations and to summarize the results of those reviews. English-language articles published between 1990 and 2000 related to antimicrobial therapy for intra-abdominal infections were identified by a systematic MEDLINE search and an examination of references included in recent review articles. If current literature with regard to a specific issue was lacking, relevant articles published prior to 1990 were identified. All prospective randomized controlled trials, as well as other articles selected by the Committee, were evaluated individually and collectively. Data with regard to patient numbers, types of infections, and results of interventions were abstracted. Studies were categorized according to their design, and all included trials were graded according to quality. On the basis of this evidence, the Committee formulated recommendations for antimicrobial therapy for intra-abdominal infections and graded those recommendations. After receiving comments from invited reviewers and the general membership of the Society, the guidelines were finalized and submitted to the Council of the Surgical Infection Society for approval. The final recommendations related to the selection of patients needing therapeutic antimicrobials, acceptable antimicrobial regimens, duration of antimicrobial use, and the identification and treatment of higher-risk patients. Although numerous publications pertaining to these topics were identified, but nearly all of the prospective randomized controlled trials represented comparisons of different antimicrobial regimens for the treatment of intra-abdominal infections. A few prospective trials evaluated the need for therapeutic antimicrobial therapy in patients with peritoneal contamination following abdominal trauma. The quality of these prospective trials was highly variable. Many did not limit enrollment to patients with complicated intra-abdominal infections, lacked blinding of treatment assignment, did not provide a complete description of the criteria used to determine therapeutic success or failure, failed to identify the reasons why patients were excluded from analysis, or did not include an intention-to-treat analysis. For many issues, no prospective randomized controlled trials were encountered, and guidelines had to be formulated using evidence from studies with historical controls or uncontrolled data, or on the basis of expert opinion

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Section: Penicillin/beta-lactamase Inhibitor Combinationsmentioning

confidence: 99%

The Surgical Infection Society Guidelines on Antimicrobial Therapy for Intra-Abdominal Infections: Evidence for the Recommendations

Mazuski

Sawyer

Nathens

et al. 2002

Surgical Infections

114

130

View full text Add to dashboard Cite

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“…El grupo inicial de once artículos, entre los cuales ocho fueron doble ciego aleatorios, uno multicéntrico aleatorio abierto, uno clínico y otro de revisión. [11][12][13][14][15][16][17][18][19][20] En nueve de los once estudios se reportó la apendicitis aguda como la principal causa de infección intraabdominal. El total de participantes fue de 3.129 pacientes, de los cuales 1.500 individuos presentaron apendicitis aguda como la causa de infección, lo que corresponde al 47.9% (Tabla 1).…”

Section: Resultsunclassified

“…11, 13-18,26. Muestra de ello es que de los nueve artículos mencionados en el grupo inicial de infecciones intraabdominales, ocho fueron diseñados con este propósito Cabe mencionar que en la revisión de los artículos en este grupo, la patología con mayor participación de pacientes fue la apendicitis aguda en cualquiera de sus fases clínicas. 11,[13][14][15][16][17][18][19] En el análisis de los resultados concuerdan, a pesar de las diferencias demográficas y temporales, en que el principal germen aislado es E. coli. 11,[13][14][15][16][17]25,28 No se reporta la proporción especifica de aislamientos por patología intraabdominal, ni el porcentaje de cultivos positivos y la proporción de estos con resultados polimicrobianos.…”

Section: Discusión Y Conclusionesunclassified

“…11,[13][14][15][16][17]25,28 No se reporta la proporción especifica de aislamientos por patología intraabdominal, ni el porcentaje de cultivos positivos y la proporción de estos con resultados polimicrobianos. [16][17][18]20,27 En el ámbito del cuadro clínico de apendicitis aguda las publicaciones tienden a ser antiguas y con un menor número de participantes. Igual que en el grupo de infecciones intraabdominales, el aerobio más frecuente fue E. coli seguido por K. pneumoniae y en cuanto a los gérmenes anaerobios el más común fue B. fragilis, sin que se describa la proporción entre los cultivos.…”

Section: Discusión Y Conclusionesunclassified

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Aislamientos bacterianos en apendicitis aguda

Pacheco¹,

Jiménez²,

Franco³

2014

Repert. Med. Cir.

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La apendicitis aguda es una patología de interés a nivel mundial con una incidencia de 100 por cada 100.000 personas/año, reportada a nivel europeo y norteamericano. La fisiopatología en forma experimental se ha relacionado con un proceso obstructivo, que evoluciona a estado isquémico favoreciendo la translocación bacteriana, por lo cual se han relacionado los distintos microorganismos como factor de importancia en el desarrollo de sus complicaciones. Se realizó una revisión de los estudios publicados en PubMed en los últimos veinte años con términos MeSH appendicitis, bacteria y etiology donde se documento la E. coli como el germen bacteriano más común y B. fragilis como un anaerobio frecuente. No se encontraron estudios que reporten perfiles de sensibilidad a resistencia antibiótica.

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“…Several prospective trials have evaluated aztreonam ϩ clindamycin against either gentamicin ϩ clindamycin or imipenem/cilastatin for complicated abdominal infections [30,49,50]. The success rate of aztreonam ϩ clindamycin was 71-100%.…”

Section: Monobactamsmentioning

confidence: 99%

Antimicrobial Therapy for Acute Colonic Diverticulitis

Byrnes

Mazuski

2009

Surgical Infections

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Background: Although guidelines and reviews have systematically evaluated diagnosis and surgical management of acute diverticulitis, they have focused only minimally on antibiotic selection for the treatment of this disease. We undertook a review of the literature to assess more clearly the use of specific antimicrobial agents in the treatment of patients with acute diverticulitis of the colon. Methods: A MEDLINE search was conducted to identify original research, review papers, and guidelines on the use of antimicrobial agents for the treatment of acute diverticulitis. Results:The general recommendation to use antibiotics with activity against common gram-negative and anaerobic pathogens has remained consistent. A number of single agents and combination regimens provide such activity. However, there is little evidence on which to base selection of specific antimicrobial regimens, and no regimen has demonstrated superiority. In general, episodes of diverticulitis severe enough to warrant hospitalization should be managed initially with intravenous antibiotics. Oral therapy can be used for outpatient treatment or when the patient's condition improves. There is a paucity of data regarding the optimal duration of antimicrobial therapy. Conclusions: Careful clinical studies are needed to evaluate better the antibiotic regimens for the treatment of acute diverticulitis. Until such studies are conducted, we are forced to rely on tradition, in vitro analyses, pharmacokinetic profiling, and indirect evidence from studies of complicated intra-abdominal infections to determine appropriate therapy for this disease.

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Comparison of imipenem/cilastatin with the combination of aztreonam and clindamycin in the treatment of intra-abdominal infections

Cited by 26 publications

References 0 publications

The Surgical Infection Society Guidelines on Antimicrobial Therapy for Intra-Abdominal Infections: Evidence for the Recommendations

The Surgical Infection Society Guidelines on Antimicrobial Therapy for Intra-Abdominal Infections: Evidence for the Recommendations

Aislamientos bacterianos en apendicitis aguda

Antimicrobial Therapy for Acute Colonic Diverticulitis

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