Treatment of polymicrobial infections: post hoc analysis of three trials comparing ertapenem and piperacillin-tazobactam.

Abstract

The efficacy of ertapenem 1 g once a day for the treatment of polymicrobial complicated intra-abdominal, complicated skin/skin-structure and acute pelvic infections was compared with piperacillin-tazobactam 3.375 g every 6 h in a post hoc analysis of data from three large randomized double-blind trials. Of the 1,558 treated patients in the three trials, no pathogen was identified in 345 (22.1%), 423 (27.2%) had a monomicrobial infection and 790 (50.7%) had a polymicrobial infection. At the test-of-cure assessment, there were no significant differences in outcome between the two treatment groups for any of the three infections. Cure rates (clinical and microbiological for intra-abdominal infection, clinical for skin/skin-structure and pelvic infections) in microbiologically evaluable patients for ertapenem and piperacillin-tazobactam, respectively, were 85.6% (154/180 evaluable patients) and 82.5% (127/154) for polymicrobial intra-abdominal infection, 80.3% (53/66) and 78.7% (48/61) for polymicrobial skin/skin-structure infection, and 95.7% (88/92) and 92.6% (88/95) for polymicrobial pelvic infection. Respective cure rates for all evaluable patients in the original trials were: 83.6% and 80.4% for intra-abdominal, 83.9% and 85.3% for skin/skin-structure, and 93.9% and 91.5% for pelvic infections. These data show that in the three trials, ertapenem 1 g once a day was highly effective for the treatment of polymicrobial infections and as effective as piperacillin-tazobactam 3.375 g every 6 h.

• Authors: Joseph Solomkin, Hedy Teppler, Donald R Graham, Richard M Gesser, Anne R Meibohm, Subir Roy, Gail L Woods
• Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 53 Suppl 2 Pg. ii51-7 (Jun 2004) ISSN: 0305-7453 [Print] England
• PMID: 15150183 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Lactams
• beta-Lactams
• Piperacillin, Tazobactam Drug Combination
• Penicillanic Acid
• Ertapenem
• Piperacillin

Topics

• Abdomen
• Adolescent
• Adult
• Anti-Bacterial Agents (therapeutic use)
• Bacteria, Aerobic (isolation & purification)
• Bacteria, Anaerobic (isolation & purification)
• Bacterial Infections (complications, drug therapy, microbiology)
• Double-Blind Method
• Ertapenem
• Female
• Humans
• Lactams (therapeutic use)
• Male
• Pelvic Infection (drug therapy, microbiology)
• Penicillanic Acid (analogs & derivatives, therapeutic use)
• Piperacillin (therapeutic use)
• Piperacillin, Tazobactam Drug Combination
• Prospective Studies
• Skin Diseases, Bacterial (drug therapy, microbiology)
• Treatment Outcome
• beta-Lactams