Comparison of sequential intravenous/oral ciprofloxacin plus metronidazole with intravenous ceftriaxone plus metronidazole for treatment of complicated intra-abdominal infections

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dc.contributor.authorWacha H.
dc.contributor.authorWarren B.
dc.contributor.authorBassaris H.
dc.contributor.authorNikolaidis P.
dc.contributor.authorVestweber K.
dc.contributor.authorPichlmayr R.
dc.contributor.authorEngemann R.
dc.contributor.authorBuchholz W.
dc.contributor.authorBuhr H.
dc.contributor.authorVon Feldmann F.
dc.contributor.authorHohenberger W.
dc.contributor.authorMeister R.
dc.contributor.authorCugnenc J.
dc.contributor.authorHuten N.
dc.contributor.authorChevallier J.-M.
dc.contributor.authorLetoublon C.
dc.contributor.authorDomergue J.
dc.contributor.authorBrimas G.
dc.contributor.authorPavalkis D.
dc.contributor.authorDrews M.
dc.contributor.authorBuchler M.
dc.contributor.authorIgra Y.
dc.contributor.authorKitzes R.
dc.contributor.authorLang R.
dc.contributor.authorSolomon M.
dc.contributor.authorSmith R.
dc.contributor.authorRaz R.
dc.contributor.authorPfeffermann R.
dc.contributor.authorDan M.
dc.contributor.authorSenninger N.
dc.contributor.authorJauch K.
dc.contributor.authorGebhardt C.
dc.date.accessioned2011-05-15T16:18:12Z
dc.date.available2011-05-15T16:18:12Z
dc.date.issued2006
dc.description.abstractBackground and Purpose: Intra-abdominal infections are a substantial clinical problem and an important cause of morbidity and death in the hospital. Optimal treatment requires both source control and antibiotic therapy. Sequential intravenous (IV) to oral therapy may improve patient convenience and reduce total health care costs. In this randomized, double-blind trial, the efficacy of sequential IV-to-oral ciprofloxacin plus metronida/ole was compared with ceftriaxone plus metronidazole in adult patients with complicated intra-abdominal infections. Methods: The trial enrolled 531 patients, who began with IV therapy. Patients who improved clinically were switched to oral therapy on day three or later. The clinical and bacteriological responses four to six weeks after the end of therapy and the safety of the two regimens were assessed. To maintain blinding, the patients received placebo IV in the ciprofloxacin group or placebo orally in the ceftriaxone group. A total of 475 patients (235 ciprofloxacin plus metronidazole, 240 ceftriaxone plus metronidazole) were valid for evaluation of efficacy. All patients were included in the safety analysis. Results: Of the patients valid for efficacy, 78% of the ciprofloxacin plus metronidazole group and 81% of the ceftriaxone plus metronidazole group were eligible for a switch to oral therapy. The clinical success rates were 98.9% and 96.9%, respectively, which were statistically equivalent. The clinical success rates for all patients, including those on continuous IV therapy, were 90.6% and 87.9%. Source control was achieved in more than 90% of the patients. The bacteriological eradication rates were similar in the two groups. Bacterial complications (e.g., surgical site infections, abscesses) were encountered more often in the ceftriaxone plus metronidazole group. Conclusions: Sequential ciprofloxacin plus metronidazole IV-to-oral therapy was statistically equivalent to ceftriaxone plus metronidazole. The switch to oral therapy with ciprofloxacin plus metronidazole was as effective and safe as continued IV therapy in patients able to tolerate enterai feeding. © Mary Ann Liebert, Inc.
dc.description.versionArticle
dc.identifier.citationSurgical Infections
dc.identifier.citation7
dc.identifier.citation4
dc.identifier.issn10962964
dc.identifier.other10.1089/sur.2006.7.341
dc.identifier.urihttp://hdl.handle.net/10019.1/14554
dc.subjectceftriaxone
dc.subjectciprofloxacin
dc.subjectmetronidazole
dc.subjectplacebo
dc.subjectantiinfective agent
dc.subjectabdominal infection
dc.subjectabscess
dc.subjectadult
dc.subjectantibiotic therapy
dc.subjectarticle
dc.subjectclinical trial
dc.subjectcomparative study
dc.subjectcontrolled clinical trial
dc.subjectcontrolled study
dc.subjectdouble blind procedure
dc.subjectdrug dose sequence
dc.subjectdrug efficacy
dc.subjectdrug safety
dc.subjectdrug withdrawal
dc.subjecteradication therapy
dc.subjectfemale
dc.subjectgastrointestinal symptom
dc.subjecthuman
dc.subjectinfection complication
dc.subjectinfection control
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmulticenter study
dc.subjectmultiple organ failure
dc.subjectpriority journal
dc.subjectrandomized controlled trial
dc.subjectsepsis
dc.subjectsurgical infection
dc.subjecttreatment response
dc.subjectunspecified side effect
dc.subjectabdomen
dc.subjectabdominal abscess
dc.subjectbacterial infection
dc.subjectdigestive system disease
dc.subjectdrug combination
dc.subjectintravenous drug administration
dc.subjectmicrobiology
dc.subjectmiddle aged
dc.subjectoral drug administration
dc.subjectAbdomen
dc.subjectAbdominal abscess
dc.subjectAdministration, Oral
dc.subjectAnti-Bacterial Agents
dc.subjectBacterial Infections
dc.subjectCiprofloxacin
dc.subjectDigestive System Diseases
dc.subjectDouble-Blind Method
dc.subjectDrug Therapy, Combination
dc.subjectFemale
dc.subjectHumans
dc.subjectInfusions, Intravenous
dc.subjectMale
dc.subjectMetronidazole
dc.subjectMiddle Aged
dc.titleComparison of sequential intravenous/oral ciprofloxacin plus metronidazole with intravenous ceftriaxone plus metronidazole for treatment of complicated intra-abdominal infections
dc.typeArticle
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