A randomized controlled trial of ampicillin plus sulbactam vs. gentamicin plus clindamycin in the treatment of intraabdominal infections: a preliminary report. Study Group of Intraabdominal Infections

Abstract

This is a preliminary report of a comparative study of sulbactam plus ampicillin (sulbactam/ampicillin) vs. gentamicin plus clindamycin (gentamicin/clindamycin) in surgically treated patients with intraabdominal infections. Among 46 assessable patients in the sulbactam/ampicillin group, 40 were clinically cured or improved as compared with 36 of 37 patients in the gentamicin/clindamycin group. Among 40 microbiologically assessable patients in the sulbactam/ampicillin group, the pathogen was eradicated in 33 patients and partially eradicated in two, whereas eradication was recorded in 21 and partial eradication in 10 of the 32 patients in the gentamicin/clindamycin group. Among 150 aerobic isolates, 14 were resistant to sulbactam/ampicillin, 27 were resistant to gentamicin/clindamycin, and 85 were beta-lactamase producers. No resistance to sulbactam/ampicillin was found in 75 anaerobic isolates, whereas one anaerobic isolate was resistant to clindamycin. This preliminary report suggests that ampicillin/sulbactam is a useful nontoxic alterative to gentamicin/clindamycin in the treatment of intraabdominal infections.