PROSPECTIVE RANDOMIZED TRIAL OF MEROPENEM VERSUS CEFOTAXIME AND METRONIDAZOL IN THE TREATMENT OF INTRAABDOMINAL INFECTIONS

BACKGROUND: The empiric antibiotic treatment of intraabdominal infecti ons is in constant evolution. Monotherapy appears to be a desirable go al because of the simplicity of ifs administration, lack of toxic effe cts and wide spectrum. PATIENTS AND METHODS: A multicentre, prospectiv e, randomized, open study was carried out to compare two antibiotic re gimens in the treatment of intraabdominal infections in patients under going surgery. Ninety-eight consecutive patients were randomly allocat ed into two groups. One group (GM, n = 51) received meropenem (1 g/8 h ) and the other (GCM, n = 47) a combination of cefotaxime (2 g/8 h) pl us metronidazol (0.5 g/8 h), Clinical and bacteriological responses we re assessed at the end of treatment and at 2-4 weeks. RESULTS: The sev erity of patients as assessed by the APACHE II score was similar in bo th groups (GM: 7.2 and GCM: 8.1), Three patients in each group could n ot be evaluated due to premature interruption of treatment or deviatio n from the protocol. The mean duration of treatment was 7.4 days in GM and 7.9 days in GCM, A satisfactory clinical response was obtained in 95% of patients in both groups. 31 patients (61%) in GM and 26 patien ts (55%) in GCM were bacteriologically evaluable. Bacteriological erra dication was achieved in 94% of patients in GM and in 92% of patients in GCM. CONCLUSION: Meropenem is a good alternative for single antibio tic therapy in intraabdominal infections of moderate severity.