ABSTRACT
The present study was carried to compare the prophylactic efficacy of parenteral single dose Cefuroxime (C) in comparison to parenteral single dose Ampicillin-Sulbactam (A+S) in patients undergoing elective cholecystectomy. Two hundred patients were randomly allocated to single dose parenterally (intra-venous) of either of the regimen before the induction of anaesthesia. Two groups were compared on the basis of American Society of Anesthesiologists (ASA) score, rate of development of wound infection, duration of surgery and hospital stay. Patients were followed up for 30 days and inspected for the development of wound infection. Frequency of bile infection and the sensitivity of the organisms to study drugs and the corelation between bile infection and risk of wound infection were also recorded. Peri-operative prophylactic antimicrobials seem to play a significant role. Both A+S and C when given prophylactically play a significant role in prevention of surgical site infections. However, A+S seems to be more effective than C in doing so in case of high risk groups. Risk of wound infection significantly increases with co existing morbidity. Bile infection does not significantly increase the risk of surgical site infection. Duration of surgery does not significantly increase the risk of wound infection. A+S and C were equally effective in preventing surgical site infections undergoing elective cholecystectomy, but A+S favored better than C in prevention of surgical site infections in high risk patients.
ABSTRACT
Objective To evaluate the efficacy of administration of ampicillin/sulbactam and imipenem/cilastatin in treatment of aspiration pneumonia in aged patients. Methods 26 aged patients was treated with aspira-tion pneumonia (2.25～3.00 g) through vessel injection twice perday,and another 26 patients was treated with imi-penem/cilastatin (0.5 g) through vessile injection every 6～8 hours. We evaluated the efficacy through assessing the temperature,the chest radiography,WBC and CRP,incidence of side effects,the time to cure and the clearance of bacteria. Results The cure rate was 84.6% (22/26) and 92.3% (24/26),respectively (χ2=0.19,P=0.66). The time to cure was 8.2±2.8 days and 7.5±1.6 days for the groups (t=1.107,P=0.274). Gastrointestinal side effects were observed in the group of ampicillin/sulbactarn;slight abnormality of liver function occurred in the group of imipenem/cilastatin ;all above adverse effects in two groups were rapidly and completely disappeared after therapy stopped. Conclusion Both ampicillin/sulbactam and imipenem/cilastatin are effective antibiotics to treat aspiration pneumonia in aged patients.
ABSTRACT
Objective To investigate the in vitro antimicrobial activity of ampicillin-sulbactam,clindamycin and cefoperazone a- gainst common clinical isolates.Methods MICs of these three antibiotics were determined by E test.Results Ampicillin-sulbae- tam showed inhibition rate of 100% for methicillin susceptible S.aureus (MSSA),E.faecalis,Group A Streptococcus,H. influenzae,penicillin-susceptible S.pneumoniae (PSSP),M.catarrhalis and anaerobes (including 10 strains of Bacteroid spp.,2 strains of P.aches,1 strain of E.lentum,1 strain of Fusobacterium innocuum,and 2 strains of Peptostreptococcus spp.).Ampicillin-sulbactam was active against 86.7% of extended-spectrum?-lactamase non-producing K.pneumoniae (NES- BL-KPN) and 53.3% of non ESBL-producing E.coli (NESBL-ECO).Ampicillin-sulbactam only inhibited 23.3% of A.bau- mannii isolates and 25.0% of E.faecium isolates.For MSSA,anaerobes,PSSP and group A Streptococcus,about 60.0%, 31.2%,30.0% and 10.0% of the isolates were susceptible to clindamycin,respectively.For MSSA,NESBL-ECO and NES- BL-KPN,96.7% to 100% of the isolates were susceptible to cefoperazone.About 40.0% of P.aeruginosa isolates were sus- ceptible to cefoperazone.No A.baumannii isolate was susceptible to cefoperazone.Conclusions The ampicillin-sulbactam has good antimicrobial activity against MSSA,E.faecalis,Group A Streptococcus,NESBL-KPN,H.influenzae,PSSP,M.ca- tarrhalis and anaerobes.In this study,clindamycin is active against 60% of MSSA isolates.Most of other species are relatively resistant to clindamycin.Cefoperazone shows good activity against MSSA,NESBL-ECO,and NESBL-KPN.These three anti- microbial agents can be used as empirical treatment for community-acquired infections.
ABSTRACT
PURPOSE: Since neonatal sepsis dose not have typical symptoms and signs, whenever suspected antibiotic therapy is the mainstay of treatment. Ampicillin-sulbactam has been widely used in the newborn nursery as the empirical antibiotics as well as ampicillin and gentamicin. The purpose of this study was to compare the efficacy and safety of amoxicillin-sulbactam to ampicillin-sulbactam in treating neonatal sepsis. METHODS: A randomized, controlled study was conducted in 60 full term neonates who were suspected to have sepsis. The patients were randomly assigned to receive amoxicillin-sulbactam 30 mg/kg/day (based on amoxicillin component) intravenously divided every 12 hours or ampicillin-sulbactam 75 mg/kg/day (based on ampicillin component) intravenously divided every 8 hours for at least 7 consecutive days. Clinical symptoms and signs, complete blood cell counts, blood chemistry and body fluid cultures were taken before, during and after the treatment. All patients were evaluated for clinical efficacy on the basis of the clinical, microbiological responses and side effects. RESULTS: The clinical success rates after 7 days of treatment were 100% for both groups. Drug related serious side effects did not occur in all patients. There were three cases (10%) of bacterial culture positive patients in amoxicillin-sulbactam treated group during treatment. But no more bacterial growth had found after 7 days antibiotics treatment. CONCLUSION: Amoxicillin-sulbactam was as effective and safe as ampicillin-sulbactam for whom neonatal sepsis was suspected.