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Ertapenem Found Effective For Intraabdominal Infections


 

MIAMI — A daily dose of intravenous ertapenem for intraabdominal infections proved as effective as piperacillin/tazobactam administered every 6 hours, Nicholas Namias, M.D., said in a poster presented at the joint annual meeting of the Surgical Infection Society and the Surgical Infection Society-Europe.

The randomized, double-blind study included 494 men and women aged at least 18 years who had systemic inflammatory responses and physical findings suggestive of intraabdominal infections resulting from surgical interventions such as open laparotomy, laparoscopic surgery, and percutaneous drainage.

A total of 247 received 1 gram of intravenous ertapenem per day and 247 received 3.375 g of intravenous piperacillin/tazobactam every 6 hours for 4–14 days, wrote Dr. Namias, of the University of Miami, and his colleagues.

Response rates were similar. A total of 122 ertapenem patients and 107 piperacillin/tazobactam patients were microbiologically evaluable at 2 weeks, and favorable clinical responses were shown in 82.1% and 81.7%, respectively. A total of 112 ertapenem patients and 94 piperacillin/tazobactam patients were microbiologically evaluable for a second follow up at 4–6 weeks, and they had response rates of 78.9% and 79.3%, respectively.

The top three organisms were Streptococcus species, Escherichia coli, and Peptostreptococcus micros. Response rates of ertapenem compared with piperacillin/tazobactam against each of these species, respectively, were 86.4% vs. 76.0%, 85.3% vs. 85.4%, and 85.0% vs. 73.3%.

A total of 69% of patients in each group reported at least one adverse experience, and 1.6% of each group discontinued the medication due to serious adverse experiences. During the course of the therapy and up to 14 days' follow-up, 6 patients in the ertapenem group died, compared with 10 patients in the piperacillin/tazobactam group. An additional two ertapenem patients and three piperacillin/tazobactam patients died due to clinical adverse events after the 14-day follow up.

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