Comparison of Moxalactam with the Combination of Clindamycin and an Aminoglycoside in the Treatment of Common Surgical Infections

Rambo, William M.; Bene, Victor E. Del; Burkey, Linda G.; Collins, Cynthia D.; Richmond, Diane K.

doi:10.1093/clinids/4.supplement_3.s683

Cited by 10 publications

(1 citation statement)

References 5 publications

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“…From those, 135 studies were excluded because the compared regimens were not β‐lactams and clindamycin/aminoglycoside combination. Sixteen studies were further excluded; four studies were excluded because they were subgroup analyses of evaluable studies, 26–29 two studies were excluded because they either used concomitant antibiotic therapy or metronidazole was also used except clindamycin in the combination with aminoglycosides, 30, 31 four studies were excluded because they were not RCTs, 32–35 five studies were excluded because the proportion of patients with intra‐abdominal infections were less than 70% of the total population, 36–40 and one study was excluded because it did not provide data about clinical outcome 41 . The remaining 28 studies met the inclusion criteria and were evaluated further 42–69 …”

Section: Resultsmentioning

confidence: 99%

Meta‐analysis: randomized controlled trials of clindamycin/aminoglycoside vs. β‐lactam monotherapy for the treatment of intra‐abdominal infections

Falagas

Matthaiou

Karveli

et al. 2007

Aliment Pharmacol Ther

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SUMMARY AimTo compare the effectiveness and safety of clindamycin ⁄ aminoglycoside with broad-spectrum b-lactam monotherapy in patients with intraabdominal infections by performing a meta-analysis of randomized controlled trials (RCTs). MethodsThe relevant 28 RCTS were retrieved from PubMed searches and reviewed by two reviewers independently.Results b-lactam monotherapy was more effective regarding cure of the infection than clindamycin ⁄ aminoglycoside (3177 clinically evaluable patients, fixed effects model, OR = 0.67, 95% CI: 0.55-0.81). The same result was found in several subset analyses. There was no difference in all-cause mortality and attributable-to-infection mortality [2382 intention-to-treat (ITT) patients, fixed effects model, OR = 1.25, 95% CI: 0.74-2.11 and 1976 ITT patients, OR = 1.19, 95% CI: 0.59-2.41, respectively]. There was no difference regarding overall adverse events and ototoxicity (1460 ITT patients, OR = 1.05, 95% CI: 0.80-1.37, and 1404 ITT patients, OR = 3.22, 95% CI: 0.72-14.45, respectively). However, treatment with clindamycin ⁄ aminoglycoside was more likely to be associated with nephrotoxicity compared to b-lactam (3065 ITT patients, OR = 3.7, 95% CI: 2.09-6.57). Clindamycin ⁄ aminoglycoside was less likely to be associated with antibiotic-associated diarrhoea compared to b-lactam (3050 ITT patients, OR = 0.68, 95% CI: 0.46-1.00). ConclusionThe results of our meta-analysis suggest that b-lactams are more effective in the treatment of intra-abdominal infections compared with clindamycin ⁄ aminoglycoside.

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