Efficacy of a β-Lactamase Inhibitor Combination for Serious Intra-abdominal Infections

Abstract

A double-blind trial was conducted in 385 patients with suspected bacterial intra-abdominal infections to compare the efficacy and safety of ampicillin-sulbactam with cefoxitin. Patients were randomized to receive either 3 g ampicillin-sulbactam (2 g ampicillin-1 g sulbactam), or 2 g cefoxitin, every 6 hours. To be evaluable, patients had to demonstrate positive culture evidence of peritoneal infection at the time of operation. A total of 197 patients were evaluable for clinical efficacy. The two treatment groups were comparable in demographic features and in the presence of risk factors for infection. Clinical success (absence of infection and of adverse drug reaction) was observed in 86% of patients in the ampicillin-sulbactam group and 78% in the cefoxitin group. Eradication of infection occurred in 88% of the ampicillin-sulbactam group and 79% of the cefoxitin group. There were no differences in the nature or frequency of side effects observed in the two groups. Ampicillin-sulbactam demonstrated no difference in safety or efficacy when compared with cefoxitin in the treatment of serious intra-abdominal infections of bacterial origin.

Resposta terapêutica e inflamatória de ratos com peritonite secundária submetidos ao uso tópico de ampicilina/sulbactam

“…O sulbactam previne a inativação da ampicilina pelas b-lactamases bacterianas, aumentando seu espectro de ação 11 .…”

“…Os macrófagos e os neutrófilos possuem receptores de superfície que evoluíram para exercer o reconhecimento de muitos constituintes comuns de A ampicilina associada ao sulbactam é um agente antimicrobiano, com atividade bactericida, indicada no tratamento da peritonite secundária, pela sua eficácia contra a maioria das bactérias aeróbicas Gram positivas, negativas e também as anaeróbias. O sulbactam previne a inativação da ampicilina pelas betalactamases bacterianas, aumentando seu espectro de ação 11 .…”

Changing trend in bile microbiology and antibiotic susceptibilities: over 12 years of experience

“…Thus, whether enterococcal coverage is necessary has been a matter of debate for decades [1]. Numerous studies have failed to demonstrate the advantage of treating enterococcal infections [33][34][35][36][37][38]. Based on these studies, the Infectious Diseases Society of America guidelines do not recommend routine coverage against Enterococcus in community-acquired infections [39].…”

Antimicrobial Therapy for Acute Colonic Diverticulitis

“…Recently, however, the use of ampicillin/sulbactam has come under scrutiny [19]. In older clinical trials, this agent appeared to perform similarly to comparators, with success rates of 86-89% [23,38]. However, a recent study of bacterial isolates from patients with intra-abdominal infections in 40 countries demonstrated a 45% rate of resistance of E. coli to ampicillin/sulbactam [39].…”