Ciprofloxacin/metronidazole versus beta-lactam-based treatment of intra-abdominal infections: a meta-analysis of comparative trials.

Abstract

Intra-abdominal infections are polymicrobial and result in substantial morbidity and mortality. The combination of ciprofloxacin/metronidazole as well as several beta-lactam-based regimens are among the commonly used regimens for the treatment of patients with such infections. Thus, we sought to review the evidence from available comparative clinical trials studying ciprofloxacin/metronidazole versus broad-spectrum beta-lactam-based regimens in the treatment of intra-abdominal infections. Studies for the meta-analysis were retrieved from searches of the PubMed database. Five available comparative trials (four randomised controlled trials and one non-randomised comparative trial) including 1431 patients with intra-abdominal infections were included in the meta-analysis. There was a statistically significant difference between the compared arms with regard to cure in favour of the ciprofloxacin/metronidazole combination (odds ratio (OR)=1.69, 95% confidence interval (CI) 1.20-2.39). There was no statistically significant difference between the compared arms with regard to total mortality (OR=1.10, 95% CI 0.71-1.69), mortality attributable to infection (OR=1.42, 95% CI 0.66-3.06) and toxicity (OR=1.25, 95% CI 0.66-2.35). In conclusion, pooled data from the available comparative trials suggest that the ciprofloxacin/metronidazole combination may be superior to beta-lactam-based therapeutic regimens in the treatment of intra-abdominal infections with regard to cure of infections, although no difference in mortality was found.

• Authors: Dimitrios K Matthaiou, George Peppas, Ioannis A Bliziotis, Matthew E Falagas
• Journal: International journal of antimicrobial agents (Int J Antimicrob Agents) Vol. 28 Issue 3 Pg. 159-65 (Sep 2006) ISSN: 0924-8579 [Print] Netherlands
• PMID: 16899353 (Publication Type: Comparative Study, Journal Article, Meta-Analysis, Review)

Chemical References

• Anti-Bacterial Agents
• beta-Lactams
• Metronidazole
• Ciprofloxacin

Topics

• Abdomen
• Anti-Bacterial Agents (administration & dosage, adverse effects, therapeutic use)
• Bacterial Infections (drug therapy, mortality)
• Ciprofloxacin (administration & dosage, adverse effects, therapeutic use)
• Drug Therapy, Combination
• Humans
• Metronidazole (administration & dosage, adverse effects, therapeutic use)
• PubMed
• Randomized Controlled Trials as Topic
• beta-Lactams (administration & dosage, adverse effects, therapeutic use)