[Comparative double-blind study of cefotetan and cefmetazole in patients with purulent peritonitis]

A clinical study of daily administrations of CTT (2g) and CMZ (4g) was performed by randomized double blind techniques in order to compare the clinical efficacy, side effects and usefulness. The 150 cases studied were as follows; Purulent peritonitis due to perforated gastrointestinal tracts (122 cases), traumatic peritonitis (4 cases), biliary peritonitis (7 cases), postoperative peritonitis (7 cases), intraabdominal abscess (6 cases); 4 cases were excluded from the statistical evaluation because of protocol deviation. 1. No significant differences in background parameters were found between the 2 groups. 2. Clinical evaluation of the efficacy rate by the attending physician revealed no significant differences between the 2 groups (CTT 82%, CMZ 74%). However, in severely perforated duodenal and/or gastric ulcer cases, greater clinical effectiveness was obtained in the CTT group than in the CMZ group (P less than 0.05). 3. Clinical evaluation of the efficacy rate by the committee revealed no significant differences between the 2 groups; 86% and 82% for the CTT and CMZ groups, respectively. However, in cases which showed marked effectiveness, although statistical significant differences were not found between the 2 groups (P less than 0.1), the CTT group (53%) was superior to the CMZ group (38%). In 122 cases of the purulent peritonitis, the efficacy rate was 92% in the CTT group and 86% in the CMZ group; this difference was also statistically significant by U-test (P less than 0.05). 4. The effectiveness was also evaluated by microbiological study in 90 cases. No significant differences were found in the ratio of eradication of isolated bacteria between the 2 groups; 30 of 44 cases (68%) in the CTT group and 34 of 46 cases (74%) in the CMZ group. 5. With regards to this eradication of bacterial strains; 115 of 119 strains (96.6%) were eradicated in the CTT group and 115 of 126 strains (91.3%) in the CMZ group. 6. Side-effects were noted in 2 cases in the CTT group; one case of nausea with chest discomfort and the other case of drug eruption. In the CMZ group, only 1 case of drug eruption was noted. Moreover, no significant differences were found in the laboratory findings between the 2 groups. Based on these results it was concluded that the clinical effectiveness of CTT (1 g twice daily) against peritonitis is as excellent as that of CMZ (2 g twice daily), both drugs being administered by drip infusion.