Prospective, randomized, comparative trials in the therapy for intraabdominal and female genital tract infections

The results of four prospective, randomized comparative trials, in which the authors' two university teaching hospitals participated, that compared selected antimicrobial regimens with the combination of clindamycin and an aminoglycoside in the therapy for intraabdominal and female genital tract infections are reviewed. In the first trial, the rates of cure for patients with intraabdominal infections were 33 (79%) of 42 treated with clindamycin and gentamicin, 43 (81%) of 53 treated with chloramphenicol and gentamicin, and 35 (90%) of 39 treated with ticarcillin and gentamicin. The rates of cure for females with genital tract infections were 16 (94%) of 17, 11 (100%) of 11, and 12 (92%) of 13 treated with the three respective combinations. The rates of cure in the second study were 22 (88%) of 25 treated with metronidazole and gentamicin and 23 (88%) of 26 treated with clindamycin and gentamicin. In the third study, the rates of cure were 23 (82%) of 28 treated with cefoxitin and tobramycin as compared with 24 (89%) of 27 treated with clindamycin and tobramycin. In the fourth study, 21 (87%) of 24 patients treated with ceftizoxime alone are cured as compared with 13 (87%) of 15 treated with clindamycin and tobramycin. These prospective, randomized trials suggest that chloramphenicol and gentamicin, ticarcillin and gentamicin, metronidazole and gentamicin, cefoxitin and tobramycin, or ceftizoxime alone are as effective as clindamycin and gentamicin or tobramycin in therapy for mixed aerobic/anaerobic infections.