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Journal of Antimicrobial Chemotherapy (2004) 53, ii51-ii57
© 2004 The British Society for Antimicrobial Chemotherapy

Supplement

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

Joseph Solomkin1, Hedy Teppler2, Donald R. Graham3, Richard M. Gesser2, Anne R. Meibohm2, Subir Roy4 and Gail L. Woods2,*

1 Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA; 2 Merck Research Laboratories, Merck & Co., Inc., West Point, PA, USA; 3 Springfield Clinic, Springfield, IL; 4 Keck School of Medicine at USC, Los Angeles, CA, USA

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 1558 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.

Keywords: mixed infections, intra-abdominal infections, skin infections, pelvic infections

Footnotes

* Corresponding author. Present address. Department of Pathology, University of Utah, ARUP Laboratories, 500 Chipeta Way, Salt Lake City, UT 84108, USA. Tel: +1-801-583-2787 ext. 2337; Fax: +1-801-584-5207; E-mail: gail.woods{at}aruplab.com


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