[Comparative clinical trial of cefoperazone versus ampicillin + tobramycin in severe bronchopulmonary and pleural infectious pathology]

This study involved an open trial with parallel randomised series receiving either cefoperazone (2 g/d) or a combination of ampicillin (6 g/d) and tobramycin (3 to 4 mg/kg/d). The 30 patients included were of both sexes (male predominance), hospitalised, aged 62 +/- 11,5 years and suffering from a severe bronchopulmonary or pleural infection. Underlying pathology was serious (neoplasm, C.O.D.L., bronchiectasis, cardiac pathology). No significant difference was seen in the sampling of the two populations. Cefoperazone was prescribed in 2 infusions per 24 hours. Ampicillin was given as 3 infusions, followed by tobramycin administered by a similar number of injections. The duration of treatment was 16.8 +/- 9 days (cefoperazone) and 11,8 +/- 6,5 days (ampicillin + tobramycin). Overall evaluation (clinical, radiological and laboratory criteria) showed 88% (cefoperazone group) and 71% (ampicillin + tobramycin group) recovery and improvement rates. There were two failures in the cefoperazone group and 6 failures in the other group. These results were not statistically different. Three of the 6 failures could be attributed to resistance of the initial bacteria or selected by one or other type of treatment. None of the antibiotics prescribed raised any acceptability problems.