CLINDAMYCIN PLUS AMIKACIN VERSUS CLINDAMYCIN PLUS AZTREONAM IN ESTABLISHED INTRAABDOMINAL INFECTIONS

Background. A prospective, randomized, single-blind study evaluated th e efficacy and safety of clindamycin plus amikacin versus clindamycin plus aztreonam (Cl-Az) in treating intraabdominal infections in adults . Methods. Patients were treated intravenously for 7 to 10 days, clind amycin 900 mg plus amikacin 5.0 mg/kg three times a day or clindamycin 900 mg plus aztreonam 2.0 gm three times a day. All 67 patients enrol led were evaluated for safety and 31 in each group for clinical and mi crobiologic response. Both groups were similar in initial diagnosis, p erforated appendicitis or intraabdominal abscess. In each group 24 pat ients (77%) were admitted in serious condition and three (10%) in crit ical condition. Twenty-five patients (80.6%) in each group had aerobic and anaerobic pathogens; the remainder had either aerobic or anaerobi c pathogens. Results. On therapy completion, clinical sand bacteriolog ic responses were as follows: clindamycin plus amikacin group, 26 (84% ) cured, 3 (9.7%) improved, and 2 (6.3%) failed; Cl-Az group, 25 (80.7 %) cured, 6 (19.3%) improved, and 0 failed. Rapid temperature decrease occurred in Cl-Az group (p = 0.007). Forty-one mild adverse medical e vents reported were evenly distributed, but no patients were removed a s a result. Conclusions. Both combinations were highly effective in ma naging intraabdominal sepsis. Clindamycin aztreonam showed a slight ad vantage because of renal toxicity and shorter time to apyrexia.