Journal of Antimicrobial Chemotherapy, Vol 39, 631-638, Copyright © 1997 by The British Society for Antimicrobial Chemotherapy
S Mehtar, EP Dewar, DJ Leaper and EW Taylor
We conducted a prospective, multi-centre, open, randomized study in 11 UK
hospitals to compare iv meropenem 1 g tds with the combination of iv
cefotaxime 1 g tds and iv metronidazole 500 mg tds in patients with serious
infections. One hundred and sixty-one patients were enrolled, of whom 131
were clinically evaluable (meropenem, n = 68; cefotaxime/metronidazole, n =
63). The most common infections were subsequent to intra-abdominal
pathology (meropenem, n = 77%; cefotaxime/metronidazole, n = 75%), and were
usually accompanied by septicaemia (meropenem, n = 61%;
cefotaxime/metronidazole, n = 53%). The incidence of a satisfactory
clinical response was similar in the two groups at the end of treatment
(93% for meropenem; 92% for cefotaxime/metronidazole) and up to 8 weeks
later (96% for meropenem; 93% for cefotaxime/metronidazole). Satisfactory
bacteriological response (success or presumed success) was recorded at the
end of therapy in 86% of meropenem and 88% of cefotaxime/metronidazole
patients. Adverse events were reported in 32% of meropenem and 25% of
cefotaxime/metronidazole patients, and most were mild or moderate and did
not require discontinuation of therapy. Twenty-one patients (ten meropenem
and 11 cefotaxime/metronidazole) died during the trial, underlining the
severity of the infections being treated in this group of patients. None of
the deaths was thought to be related to study therapy.
RANDOMIZED CONTROLLED TRIAL
A multi-centre study to compare meropenem and cefotaxime and metronidazole in the treatment of hospitalized patients with serious infections
North Middlesex Hospital, Edmonton, London, UK.
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