RESULTS OF A RANDOMIZED TRIAL COMPARING SEQUENTIAL INTRAVENOUS ORAL TREATMENT WITH CIPROFLOXACIN PLUS METRONIDAZOLE TO IMIPENEM-CILASTATIN FOR INTRAABDOMINAL INFECTIONS

Objective In a randomized, double-blind, multicenter trial, ciprofloxa cin/metronidazole was compared with imipenem/cilastatin for treatment of complicated intra-abdominal infections. A secondary objective was t o demonstrate the ability to switch responding patients from intraveno us (IV) to oral (PO) therapy. Summary Background Data Intra-abdominal infections result in substantial morbidity, mortality, and cost. Antim icrobial therapy often includes a 7- to 10-day intravenous course. The use of oral antimicrobials is a recent advance due to the availabilit y of agents with good tissue pharmacokinetics and potent aerobic gram- negative activity. Methods Patients were randomized to either ciproflo xacin plus metronidazole intravenously (CIP/MTZ IV) or imipenem intrav enously (IMI IV) throughout their treatment course, or ciprofloxacin p lus metronidazole intravenously and treatment with oral ciprofloxacin plus metronidazole when oral feeding was resumed (CIP/MTZ IV/PO). Resu lts Among 671 patients who constituted the intent-to-treat population, overall success rates were as follows: 82% for the group treated with CIP/MTZ IV; 84% for the CIP/MTZ IV/PO group; and 82%.