RANDOMIZED COMPARATIVE TRIAL WITH AMPICILLIN SULBACTAM VERSUS CEFAMANDOLE IN THE THERAPY OF COMMUNITY-ACQUIRED PNEUMONIA/

In a randomized prospective study ampicillin/sulbactam and cefamandole were compared in the therapy of patients hospitalized with community acquired pneumonia. Patients receiving ampicillin/sulbactam (n = 37) a nd cefamandole (n = 38) were similar with respect to age (mean age 70 vs. 76 years respectively), clinical characteristics, severity of illn ess and underlying disease. Pathogens isolated from patients in the ce famandole and ampicillin/sulbactam group, respectively, were Streptoco ccus pneumoniae (7 vs. 7 patients), Haemophilus parainfluenzae (7 vs. 6 patients), Haemophilus influenzae (5 vs. 5 patients), Staphylococcus aureus (5 vs. 4 patients), Escherichia coli (4 vs. 4 patients), Klebs iella pneumoniae (3 vs. 3 patients), Enterobacter spp. (2 vs. 3 patien ts), Moraxella catarrhalis (1 vs. 2 patients), and organisms of the or al flora (4 vs. 3 patients). The rate of resistance to penicillin was 80 %, to clindamycin 76 %, to erythromycin 45 %, to ampicillin 43 %, a nd to cefazolin 18 %. Overall successful treatment rates of 81 % for c efamandole and 97 % for ampicillin/sulbactam (p = 0.05) were observed. Both cefamandole and ampicillin/sulbactam were shown to be effective agents for therapy of community acquired pneumonia; however ampicillin /sulbactam demonstrated superior overall clinical efficacy.