Document Detail


Aztreonam vs. cefotaxime in the treatment of gram-negative spontaneous peritonitis in cirrhotic patients.
MedLine Citation:
PMID:  2066075     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Aztreonam and cefotaxime were compared in 44 cirrhotic patients who had 52 episodes of gram-negative spontaneous peritonitis. Patients were randomized into two therapeutic groups of similar characteristics. Group A (28 episodes) received 0.5 gm of aztreonam every 8 hr, and group B (24 episodes) received 1 gm of cefotaxime every 6 hr, for a planned 14-day period. Peak and trough serum and ascitic fluid levels of both antibiotics were several times higher than the minimum inhibitory concentrations of causative microorganisms. Eleven patients (21%) died within the first 48 hr after beginning therapy, which included seven in the aztreonam group and four in the cefotaxime group. In the remaining patients, signs and symptoms of infection were promptly controlled, and ascitic fluid cultures became negative after 48 hr in all cases, except in one patient from the aztreonam group, who was a clinical failure. Two patients from the aztreonam group and one from the cefotaxime group relapsed after treatment. The overall mortality rate was 50%, which was lower than classically reported: 12 patients (43%) died in the aztreonam group, and 14 (58%) died in the cefotaxime group (p = 0.265, NS). Hepatorenal syndrome and digestive tract hemorrhage were the most frequent causes of death occurring after the first 48 hr of treatment. Streptococcal superinfections developed in three patients (14.2%) in the aztreonam group. We conclude that both antibiotics at the low doses used in this study are similarly well tolerated and effective in controlling this infection. Because the use of aztreonam as the initial empirical treatment requires a concomitant antibiotic against gram-positive infections and the possibility of streptococcal superinfections, cefotaxime seems to be a more advantageous therapeutic alternative for this patient population.
Authors:
J Ariza; X Xiol; M Esteve; F Fernández Bañeres; J Liñares; T Alonso; F Gudiol
Related Documents :
2188905 - Efficacy of two different dec regimens in the treatment of human filarial infection.
12590855 - Comparison of the efficacy and safety of moxifloxacin and trovafloxacin for the treatme...
7585845 - Single daily dose of cefodizime in patients with community-acquired pneumonia: an open-...
18159405 - Oral fluoroquinolones in the treatment of pneumonia, bronchitis and sinusitis.
17041915 - Association of cigarette smoking and depressive symptoms in a forensic population.
21320525 - Agreement of accelerometer and a physical activity questionnaire in adults with intelle...
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  14     ISSN:  0270-9139     ISO Abbreviation:  Hepatology     Publication Date:  1991 Jul 
Date Detail:
Created Date:  1991-08-12     Completed Date:  1991-08-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  91-8     Citation Subset:  IM    
Affiliation:
Department of Medicine, Hospital de Bellvitge, University of Barcelona, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Ascitic Fluid / complications,  metabolism
Aztreonam / blood,  therapeutic use*
Bacterial Infections*
Cefotaxime / blood,  therapeutic use*
Female
Gram-Negative Bacteria*
Humans
Kidney / physiopathology
Liver Cirrhosis / complications*
Male
Middle Aged
Peritonitis / complications,  microbiology*,  physiopathology
Prospective Studies
Superinfection / microbiology
Chemical
Reg. No./Substance:
63527-52-6/Cefotaxime; 78110-38-0/Aztreonam

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Persistence of hepatitis B viral DNA after serological recovery from hepatitis B virus infection.
Next Document:  The effects of embryonic treatments with gonadal hormones on sexually dimorphic behavior of chicks.