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Piperacillin compared with cefuroxime plus metronidazole in diffuse peritonitis.
M Paakkonen1, E M Alhava, R Huttunen
1University Hospital, Kuopio, Finland.
The European Journal of Surgery = Acta Chirurgica
|September 1, 1991
Summary
Piperacillin and cefuroxime plus metronidazole showed similar effectiveness for treating diffuse peritonitis after surgery. This study found no significant difference in treatment success rates between the two antibiotic regimens for this common surgical complication.
Area of Science:
- Infectious Diseases
- Surgical Infections
- Pharmacology
Background:
- Diffuse peritonitis is a serious intra-abdominal infection often requiring surgical intervention.
- Antibiotic therapy is crucial for managing peritonitis, but optimal regimens are debated.
- Secondary peritonitis arises from a perforated or ruptured viscus.
Purpose of the Study:
- To compare the efficacy of piperacillin versus cefuroxime plus metronidazole in treating diffuse secondary peritonitis.
- To evaluate treatment success rates and pathogen burden in patients receiving either antibiotic regimen.
Main Methods:
- Eighty-five patients with diffuse peritonitis were randomized to receive either piperacillin (n=38) or cefuroxime plus metronidazole (n=45).
- Treatment success was assessed in 78 evaluable patients.
- Mean pathogen load per patient was determined for each group.
Main Results:
- Successful treatment was observed in 71% of patients receiving piperacillin and 64% receiving cefuroxime plus metronidazole.
- The mean number of identified pathogens per patient was 1.5 in the piperacillin group and 1.7 in the cefuroxime/metronidazole group.
- No statistically significant difference in efficacy was found between the two treatment arms.
Conclusions:
- Piperacillin is therapeutically equivalent to cefuroxime plus metronidazole for managing diffuse secondary peritonitis.
- Both antibiotic regimens demonstrate comparable effectiveness in treating this complex surgical infection.