Piperacillin-tazobactam versus imipenem-cilastatin for treatment of intra-abdominal infections

Antimicrob Agents Chemother. 1992 Dec;36(12):2766-73. doi: 10.1128/AAC.36.12.2766.

Abstract

In order to compare the clinical and microbiological efficacies and safety of piperacillin plus tazobactam with those of imipenem plus cilastatin, 134 patients with intra-abdominal infections (73 patients with appendicitis) participated in an open randomized comparative multicenter trial. A total of 40 men and 29 women (mean age, 53 years; age range, 18 to 92 years) were enrolled in the piperacillin-tazobactam group and 40 men and 25 women (mean age, 54 years; age range, 16 to 91 years) were enrolled in the imipenem-cilastatin group. The patients received either piperacillin (4 g) and tazobactam (500 mg) every 8 h or imipenem and cilastatin (500 mg each) every 8 h. Both regimens were given by intravenous infusion. A total of 113 patients were clinically evaluable. Of 55 patients who received piperacillin-tazobactam, 50 were clinically cured, while 40 of 58 patients in the imipenem-cilastatin group were clinically cured. The differences were significant (Wilcoxon test; P = 0.005). There were 4 failures or relapses in the piperacillin-tazobactam group and 18 failures or relapses in the imipenem-cilastatin group. The microorganisms isolated were eradicated in similar proportions in the two patient groups. Adverse reactions, mainly gastrointestinal disturbances and nausea, were noted in 13 patients who received piperacillin-tazobactam and in 14 patients who received imipenem-cilastatin. Results of the present study show that piperacillin-tazobactam is effective and safe for the treatment of intra-abdominal infections.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Abdomen*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / microbiology
  • Cilastatin / adverse effects
  • Cilastatin / therapeutic use
  • Cilastatin, Imipenem Drug Combination
  • Drug Combinations
  • Drug Therapy, Combination / adverse effects
  • Drug Therapy, Combination / therapeutic use*
  • Female
  • Humans
  • Imipenem / adverse effects
  • Imipenem / therapeutic use
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Penicillanic Acid / adverse effects
  • Penicillanic Acid / therapeutic use
  • Piperacillin / adverse effects
  • Piperacillin / therapeutic use
  • Tazobactam
  • Treatment Outcome
  • beta-Lactamase Inhibitors*

Substances

  • Anti-Bacterial Agents
  • Drug Combinations
  • beta-Lactamase Inhibitors
  • Cilastatin
  • Imipenem
  • Penicillanic Acid
  • Cilastatin, Imipenem Drug Combination
  • Tazobactam
  • Piperacillin