Source: Harefuah  |  Posted 8 years ago

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[].