Comparison of the safety and efficacy of parenteral ticarcillin / clavulanate and clindamycin / gentarnicin in serious intra - abdominal infections Mitchell

One hundred and twelve pati ents with proven or suspected serious intraabdominal infection s were randomized for treatm ent with either ticarci llin/clavulanate (ll g every 4 h) or gentamicin (dosage schedule adjusted according to serum concentra­ tions) plus c1indam ycin (in most cases 900 mg every 8 h), Positive intraperitoneal and/or blood cultures were available in 47 cases, Considering only fully evaluable cases, 15/20 (75%) were clinically cured or improved in the ticarcillin/c1avulanate group and 16/25 (64%) in the gentarnicin/clindarnycin group, (he difference not being significant (P > 0,05). Bacteraemia was documented in nine of 45 fully evaluabl e cases, During the course of the study, the serum creatinine concentrat ion increased by more than 5 mg/l in only one patient (ticarcillin/clavul an ate group) , Two patients (one in each group) had apparent allergic reaction s, No other drug­ related adverse effects WC \'e noted, In-vitro sensitivity testing of anaerobic isolates revealed that, of those tested, 5/38, 1/38 and 2/37 were resistant to ticarcillin, ticarcillin/clavulan ate and clinda rnycin, respectively, Among aerobic Gram-negati ve isolates, 34/78, 6/78 and 4/78 were resistant to ticarcillin, ticarcillin/clavul an ate , and gentamicin, respectively . Among aerobic Gram-positive isolates, 2/32, 2/32 and 5/14 were resistant to ticarcillin , ticarcillin/clavulanate, and c1indamycin, respectively, W.e conclude that ticarcillin/clavulanate is a safe an<!,dficacious preparation for treating serious intr a-abdominal infections,