Prospective randomized comparison of mezlocillin therapy alone with combined ampicillin and gentamicin therapy for patients with cholangitis

Autor: Wolfe B. Gerecht, Nancy K. Henry, Sharon M. Muller, Nicholas F. LaRusso, Jon E. Rosenblatt, Wendell W. Hoffman, Walter R. Wilson
Rok vydání: 1989
Předmět:
Zdroj: Archives of Internal Medicine. 149:1279-1284
ISSN: 0003-9926
DOI: 10.1001/archinte.149.6.1279
Popis: • Forty-six patients with cholangitis were randomized to receive therapy with mezlocillin sodium (24 patients) or a combination of ampicillin sodium—gentamicin sulfate (22 patients). The biliary concentration of mezlocillin was 112 times higher than that of ampicillin and 778 times higher than that of gentamicin. The ratio of the concentration in serum or bile over the minimum inhibitory concentration against aerobic gram-negative bacilli (therapeutic index) was higher for mezlocillin than for either ampicillin or gentamicin. Twenty (83%) of 24 patients were cured following mezlocillin therapy compared with 9 (41%) of 22 patients after ampicillin-gentamicin therapy. The 3 patients with superinfection were in the ampicillin-gentamicin arm of the study. Fewer toxic or adverse effects occurred in association with mezlocillin treatment than with ampicillin-gentamicin treatment. Mezlocillin therapy was more effective, less toxic, and less expensive than treatment with ampicillin and gentamicin for patients with cholangitis. ( Arch Intern Med . 1989;149:1279-1284)
Databáze: OpenAIRE