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Cefoperazone compared with ampicillin plus tobramycin for severe biliary tract infections
M G Bergeron1, J Mendelson, G K Harding
1Le Centre Hospitalier de l'Université Laval, Quebec, Canada.
Antimicrobial Agents and Chemotherapy
|August 1, 1988
Summary
Cefoperazone demonstrated superior efficacy over ampicillin-tobramycin for severe biliary tract infections, achieving higher cure rates and lower pathogen resistance. This makes cefoperazone an excellent alternative for treating these serious infections.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Medicine
Background:
- Severe acute biliary tract infections pose significant therapeutic challenges.
- Empirical antibiotic therapy is crucial, but pathogen resistance can limit treatment effectiveness.
Purpose of the Study:
- To compare the efficacy and safety of cefoperazone versus ampicillin-tobramycin as initial therapy for severe acute biliary tract infections.
Main Methods:
- A prospective, randomized, multicenter study involving 67 patients with confirmed severe biliary tract infections.
- Patients received either cefoperazone or a combination of ampicillin-tobramycin.
- Clinical and microbiological cure rates, as well as pathogen resistance patterns, were assessed.
Main Results:
- Cefoperazone achieved a higher clinical cure rate (97%) compared to ampicillin-tobramycin (82%), though not statistically significant (P=0.07).
- Microbiological cure rates were significantly higher with cefoperazone (94%) than ampicillin-tobramycin (62%) (P=0.03).
- Pathogen resistance was significantly lower for cefoperazone (1%) compared to ampicillin (51%) and tobramycin (4%) (P<0.001). Cefoperazone achieved high biliary concentrations.
Conclusions:
- Cefoperazone is an effective and safe alternative for treating severe acute biliary tract infections.
- Its favorable pharmacokinetic profile and low resistance rates support its use, especially in cases with potential ampicillin resistance.