[Comparison of efficacy between ceftriaxone and cefoperazone plus sulbactam in peri-operative treatment of acute suppurative cholangitis].

Abstract

OBJECTIVE:

To compare the efficacy of ceftriaxone and that of cefoperazone plus sulbactam (sulperazon) in controlling infection, in scavenging bacteria from bile, and in their costs when treating acute suppurative cholangitis with choledochostomy.

METHODS:

Patients were randomly assigned to two groups: the ceftriaxone group (R-group, n=95) and sulperazon group (S-group, n=95). Before choledochostomy, both groups received one intravenous dose of the corresponding antibiotics: and 2 g ceftriaxnoe for the R-group, 2 g sulperazon, containing 1 g cefoperazone and 1 g sulbactam, for the S-group. After the operation, the patients in the R-group received ceftriaxone 2 g i.v. q.d.; the patients in the S-group received sulperazon 2 g i.v. b.i.d.. In addition, all patients in both groups received metronidazole 0.5 g daily before and after the operation. The efficacy was evaluated by efficiency in controlling infection and the persisting days of symptoms due to infection, fever and leukocytosis; the persisting days was compared using the life table method to calculate the "cumulative probability of persistence of symptoms (CPPS)". The two groups were also compared in regards to their biliary bacterial clearance rates and the costs directly attributable to the antibiotics.

RESULTS:

The efficiency in controlling infection was 98.9% (94/95) in both groups. However, the CPPS of the R-group decreased more rapidly than that of the S-group, Log-Rankchi2=6.7901, P=0.0092. Biliary bacterial clearance rate on post-operative day 3 was 72.0% (36/50) for the R-group, 41.3% (19/46) for the S-group, P=0.0037. Cost directly attributable to the antibiotics were (1788.29 +/- 518.46) yuan (RMB) for the R-group, and (3768.74 +/- 820.55) yuan for the S-group, F=395.51, P=0.0000.

CONCLUSION:

Both ceftriaxone and sulperazon are effective in treating acute suppurative cholangitis when used before and after choledochostomy. Ceftriaxone is superior in expediting symptom relief and bacterial clearance from bile, and is more cost-effective.

• Authors: Xiao-si Zhou, Sheng-quan Zou, Jia-hong Dong, Wei-ze Wu, Yang-de Zhang, Tong-lin Zhang, Zhong Zeng, Nian-feng Li, Guo-tong Man
• Journal: Zhonghua yi xue za zhi (Zhonghua Yi Xue Za Zhi) Vol. 84 Issue 22 Pg. 1879-82 (Nov 17 2004) ISSN: 0376-2491 [Print] China
• PMID: 15631798 (Publication Type: Clinical Trial, Comparative Study, English Abstract, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Anti-Bacterial Agents
• Ceftriaxone
• Cefoperazone
• Sulbactam

Topics

• Acute Disease
• Adolescent
• Adult
• Aged
• Anti-Bacterial Agents (therapeutic use)
• Cefoperazone (economics, therapeutic use)
• Ceftriaxone (economics, therapeutic use)
• Cholangitis (drug therapy)
• Cost-Benefit Analysis
• Drug Therapy, Combination
• Female
• Humans
• Male
• Middle Aged
• Perioperative Care
• Postoperative Period
• Prospective Studies
• Sulbactam (economics, therapeutic use)
• Suppuration (drug therapy)