A COMPARISON OF IMIPENEM CILASTATIN WITH THE COMBINATION OF CEFUROXIME AND METRONIDAZOLE IN THE TREATMENT OF INTRAABDOMINAL INFECTIONS/

515 patients with intra-abdominal infection participated in an open ra ndomized comparative multicenter trial in order to compare the efficac y, safety, and tolerance of imipenem/cilastatin with cefuroxime/metron idazole. 258 patients (mean age 56 years) received imipenem/cilastatin 1.5-2.0 g/day, and 257 patients (mean age 54 years) received cefuroxi me 3.0-4.5 g/day plus metronidazole 1.0-1.5 g/day for at least 3 days. 130/161 evaluable patients (80.8%) receiving imipenem/cilastatin and 124/145 evaluable patients (85.5%) receiving cefuroxime/metronidazole were clinically cured. The micobiological response was favorable in 86 .9% in the imipenem/cilastatin group and in 90.8% in the cefuroxime/me tronidazole group. The two treatment groups sere similar with respect to median time to defervescence which was 4 days. The median duration of treatment was 6 days and the median time to discharge from hospital was 9 days in both groups. Drug-related adverse reactions were observ ed in 14 patients receiving imipenem/cilastatin and in 8 patients rece iving cefuroxime/metronidazole. 19 patients in the imipenen/cilastatin group and 12 patients in the cefuroxime/metronidazole group died. No correlation was found between the deaths and the study drugs. The pres ent study shows that intra-abdominal infections can be treated succces sfully with imipenem/cilastatin as well as with cefuroxime/metronidazo le.