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Prospective Study Comparing Imipenem-Cilastatin With Clindamycin and Gentamicin for the Treatment of Serious Surgical Infections
Alan W. Hackford, MD;
Francis P. Tally, MD;
Randolph B. Reinhold, MD;
Michael Barza, MD;
Sherwood L. Gorbach, MD
Arch Surg. 1988;123(3):322-326.
Abstract
• Surgical infection remains a leading cause of hospital morbidity and mortality. We compared the efficacy and toxicity of imipenem—cilastatin sodium in 32 patients with that of clindamycin phosphate and gentamicin sulfate in 25 patients. In the imipenem-cilastatin group, 87.5% had a favorable outcome, with a 12.5% failure rate and 13 adverse reactions. In the clindamycin-gentamicin group, 80% had a favorable outcome, with a 20% failure rate and ten adverse reactions. Two significant superinfections with Pseudomonas and Candida were noted in patients treated with impenem-cilastatin. Each group had one case of Clostridium difficile—associated colitis. Cost analysis showed no differences between treatment arms, except in the appendicitis subgroup. For serious surgical infections, single-agent therapy with imipenem-cilastatin appears to be as efficacious as combination therapy with clindamycin and gentamicin.
(Arch Surg 1988;123:322-326)
Author Affiliations
From the Departments of Surgery (Drs Hackford and Reinhold), Medicine (Infectious Disease Division) (Drs Tally and Barza), and Community Health (Dr Gorbach), Tufts University School of Medicine and New England Medical Center Hospitals, Boston.
Footnotes
Accepted for publication May 26, 1987.
Read before the Seventh Annual Meeting of the Surgical Infection Society, Philadelphia, May 11, 1987.
Reprint requests to the Department of Surgery, New England Medical Center, 750 Washington St, Boston, MA 02111.
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