Journal of Antimicrobial Chemotherapy (2004) 53, ii59-ii66
© 2004 The British Society for Antimicrobial Chemotherapy
Supplement |
Ertapenem versus ceftriaxone for the treatment of community-acquired pneumonia in adults: combined analysis of two multicentre randomized, double-blind studies
1 Hospital Santa Clara, Bogota, Colombia; 2 Pulmonary Center of the City of Vienna, Vienna, Austria; 3 Merck Research Laboratories, West Point, PA, USA
Abstract
The efficacy and safety of ertapenem, 1 g once a day, for the treatment of community-acquired pneumonia (CAP) requiring parenteral therapy were compared with those of ceftriaxone, 1 g once a day, in 866 hospitalized adults randomized in two prospective, double-blind, multicentre studies. Patients were stratified according to Pneumonia Severity Index (
3 or >3) or age (65 or >65 years). After 
3 days of parenteral antimicrobial therapy, patients who had clinically improved could be switched to oral co-amoxiclav. The median durations of parenteral, oral and total therapy in the 658 clinically evaluable patients, of whom 88% were switched to oral therapy, were 4, 7 and 12 days, respectively, in both treatment groups. The most common pathogen was Streptococcus pneumoniae, of which 79% (143/181) were penicillin susceptible and 3.3% (6/181; three in each treatment group) were penicillin resistant. Cure rates for the two treatments were equivalent: 91.9% for ertapenem and 92.0% for ceftriaxone (95% confidence interval for the difference, adjusted for strata: –4.5 to 4.4). Cure rates in the different severity and age strata and bacterial eradication rates for both treatment groups were also similar. The most common drug-related adverse events in both treatment groups were diarrhoea and mild-to-moderate elevations in aminotransferase levels. The results of these studies demonstrate that ertapenem, 1 g once a day, was highly effective therapy for CAP in hospitalized adults with moderate-to-severe disease.
Keywords: clinical trials, bacterial pneumonia, antibiotic therapy, carbapenems
Footnotes
* Corresponding author. Merck & Co., Inc., BL3–4, PO Box 4, West Point, PA 19486-0004, USA. Tel: +1-344-2406; Fax: +1-484-344-7637; E-mail: robin_isaacs{at}merck.com
Present address. Department of Pathology, University of Utah, ARUP Laboratories, 500 Chipeta Way, Salt Lake City, UT 84108, USA.
¶ Present address: Peninsula Pharmaceuticals, 1751 Harbor Bay Parkway, Alameda, CA 94502, USA.
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