TICARCILLIN CLAVULANATE COMPARED WITH CLINDAMYCIN GENTAMICIN (WITH ORWITHOUT AMPICILLIN) FOR THE TREATMENT OF INTRAABDOMINAL INFECTIONS INPEDIATRIC AND ADULT PATIENTS

Combinations of penicillins with beta-lactamase inhibitors have become acceptable treatments for mixed bacterial infections. The objective o f this multicenter, randomized, open-label study was to compare the ef ficacy, safety, and tolerance of ticarcillin/clavulanate with clindamy cin/gentamicin (with or without ampicillin) when administered to adult and pediatric patients with intra-abdominal infections. A total of 99 3 patients 2 years of age or older were entered in this trial if they had suspected or bacteriologically documented intra-abdominal infectio n, Of these, 341 were determined at the time of operation to have intr a-abdominal infection. Cure rates at the time of final assessment were 79%, 80%, and 82% for ticarcillin/clavulanate, and clindamycin/gentam icin without or with ampicillin, respectively (P = 0.829, Cochran-Mant el-Haenszel). The most frequent reason for failure was development of an intra-abdominal abscess (6% of patients overall), followed by wound infections (4%), and persistent fever (3%). Two patients who had rece ived ticarcillin/clavulanate and five who had received clindamycin/gen tamicin required discontinuation of the study regimen because of adver se drug reactions. The bacteria isolated most frequently from study fa ilures were E. coli, B. fragilis, Pseudomonas, and Streptococci. In th is study, ticarcillin/clavulanate was as effective as the combination of clindamycin/gentamicin for the treatment of intra-abdominal infecti ons.