Efficacy and cost of ampicillin-sulbactam and ticarcillin-clavulanate in the treatment of hospitalized patients with bacterial infections

Study Objective. To evaluate the efficacy and cost of treatment with two be ta-lactam/beta-lactamase-inhibitor combinations. Design. Retrospective, open-label multicenter study. Setting. Fifty-four hospitals across the United States. Patients.: Eight hundred ninety patients with skin and soft tissue, intraab dominal, gynecologic, respiratory, urinary tract, or other infections that required parenteral antibiotic therapy. Intervention. Patients were administered either ampicillin-sulbactam 1.5 or 3.0 g every 6 hours or ticarcillin-clavulanate 3.1 g every 6 hours. Measurements and Main Results. The agents did not differ significantly in e fficacy for most infections; although, ampicillin-sulbactam was bacteriolog ically superior to ticarcillin-clavulanate in the treatment of intraabdomin al infections (p=0.0011). Costs of ampicillin-sulbactam, particularly the 1 .5-g dose, were lower than those of ticarcillin-clavulanate for skin and so ft tissue (p<0.001), intraabdominal (p=0.005), and respiratory tract (p<0.0 01) infections. Conclusion. Ampicillin-sulbactam provides effective coverage for patients w ith the above infections and is as effective as the broader-spectrum agent.