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Piperacillin monotherapy compared with metronidazole and gentamicin combination in penetrating abdominal trauma
E H Sims1, M A Lou, S W Williams
1Department of Surgery, King Drew Medical Center, Los Angeles, CA 90059.
Abstract:
The therapeutic efficacy and safety of piperacillin (4.5 g, every 6 hours) were compared with combined gentamicin (80 mg, every 8 hours) and metronidazole (500 mg every 6 hours) therapy in 246 patients hospitalized for penetrating abdominal injuries. Sixty-five patients had penetrating injury of the colon, rectum, or terminal ileum. The overall clinical cure rate was about 94% in both treatment groups. Adverse clinical experiences or biochemical abnormalities required discontinuation of therapy in three patients on gentamicin/metronidazole and in no patients on piperacillin.
Insights
Piperacillin demonstrated comparable efficacy to gentamicin and metronidazole for abdominal injury treatment. Piperacillin showed a better safety profile, with fewer treatment discontinuations due to adverse events.
Area of Science:
- Infectious Diseases
- Surgical Infections
- Pharmacology
Background:
- Penetrating abdominal injuries often necessitate antibiotic therapy to prevent and treat infections.
- Current treatment guidelines may involve broad-spectrum antibiotics like gentamicin and metronidazole.
Purpose of the Study:
- To compare the therapeutic efficacy and safety of piperacillin versus a combination of gentamicin and metronidazole in patients with penetrating abdominal injuries.
Main Methods:
- A comparative study involving 246 hospitalized patients with penetrating abdominal injuries.
- Patients received either piperacillin (4.5 g every 6 hours) or combined gentamicin (80 mg every 8 hours) and metronidazole (500 mg every 6 hours).
- Focus on patients with injuries to the colon, rectum, or terminal ileum (n=65).
Main Results:
- An overall clinical cure rate of approximately 94% was observed in both treatment groups.
- Piperacillin therapy resulted in no discontinuations due to adverse events.
- Gentamicin/metronidazole therapy required discontinuation in three patients due to adverse clinical experiences or biochemical abnormalities.
Conclusions:
- Piperacillin is a safe and effective therapeutic option for penetrating abdominal injuries.
- Piperacillin offers a favorable safety profile compared to the combination of gentamicin and metronidazole, with a lower incidence of treatment-limiting adverse events.