T.E.A. Study: three-day ertapenem versus three-day Ampicillin-Sulbactam

Fausto Catena, Carlo Vallicelli, Luca Ansaloni, Massimo Sartelli, Salomone Di Saverio, Riccardo Schiavina, Eddi Pasqualini, Annalisa Amaduzzi, Federico Coccolini, Michele Cucchi, Daniel Lazzareschi, Gian Luca Baiocchi, Antonio D Pinna, Fausto Catena, Carlo Vallicelli, Luca Ansaloni, Massimo Sartelli, Salomone Di Saverio, Riccardo Schiavina, Eddi Pasqualini, Annalisa Amaduzzi, Federico Coccolini, Michele Cucchi, Daniel Lazzareschi, Gian Luca Baiocchi, Antonio D Pinna

Abstract

Background: Intra-abdominal infections are one of the most common infections encountered by a general surgeon. However, despite this prevalence, standardized guidelines outlining the proper use of antibiotic therapy are poorly defined due to a lack of clinical trials investigating the ideal duration of antibiotic treatment. The aim of this study is to compare the efficacy and safety of a three-day treatment regimen of Ampicillin-Sulbactam to that of a three-day regimen of Ertapenem in patients with localized peritonitis ranging from mild to moderate severity.

Methods: This study is a prospective, multi-center, randomized investigation performed in the Department of General, Emergency, and Transplant Surgery of St. Orsola-Malpighi University Hospital in Bologna, Italy. Discrete data were analyzed using the Chi-squared and Fisher exact tests. Differences between the two study groups were considered statistically significant for p-values less than 0.05.

Results: 71 patients were treated with Ertapenem and 71 patients were treated with Ampicillin-Sulbactam. The two groups were comparable in terms of age and gender as well as the site of abdominal infection. Post-operative infection was identified in 12 patients: 10 with wound infections and 2 with intra-abdominal infections. In the Ertapenem group, 69 of the 71 patients (97%) were treated successfully, while the therapy failed in 2 cases (3%). Therapy failures were more frequent in the Unasyn group, amounting to 10 of 71 cases (p = 0.03).

Conclusion: According to these preliminary findings, the authors conclude that a three-day Ertapenem treatment regimen is the most effective antibiotic therapy for patients with localized intra-abdominal infections ranging from mild to moderate severity.

Trial registration: Trial registration: ClinicalTrials.gov: NCT00630513.

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Source: PubMed

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