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Similar Cure Rates With Ertapenem Or Piperacillin-Tazobactam For Surgical Infections With Or Without Enterococcus
A DGReview of :"Surgical Infections with Enterococcus: Outcome in Patients Treated with Ertapenem versus Piperacillin-Tazobactam"
Surgical Infections (Larchmt)
04/29/2003
By James Adams
Antimicrobial therapy with either ertapenem or piperacillin-tazobactam results in similar cure rates in patients with surgical infection with or without Enterococcus.
Investigators from Merck Research Laboratories in West Point, Pennsylvania, United States, studied 1,558 patients from 3 randomised triple-blind studies. Patients had intra-abdominal infection, complicated skin and skin structure infection or acute pelvic infection.
Two hundred twenty-three of the patients had infections with Enterococcus in initial cultures.
Results of logistic regression analyses showed that cure rates for ertapenem and piperacillin-tazobactam treatment groups were similar in all three studies, regardless of Enterococcus presence.
Patients with Enterococcus had significantly lower cure rates than patients without Enterococcus for intra-abdominal infection and complicated skin and skin structure infection. Cure rates were similar for patients with acute pelvic infection with or without Enterococcus.
Pseudomonas aeruginosa as a baseline pathogen was predictive of the presence of Enterococcus for intra-abdominal disease. Older age and the presence of a complicating underlying disease were predictive for Enterococcus in complicated skin and skin structure infection. Moderate rather than severe infection ratings were predictive of Enterococcus in acute pelvic infection.
Treatment failure was predicted by greater than two days of postoperative infection at study entry for intra-abdominal infection and older age for complicated skin and skin structure infection.
The investigators conclude that choice of ertapenem or piperacillin-tazobactam does not affect cure rates in patients with or without Enterococcus.
Surg Infect (Larchmt) 2002;3:4:337-349.
"Surgical Infections with Enterococcus: Outcome in Patients Treated with Ertapenem versus Piperacillin-Tazobactam"
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