[Treatment of intra-abdominal infections with beta-lactam antibiotics. Results of some controlled prospective studies].

Between April, 1980 and August, 1985, 240 patients were operated on for localised or generalised intraabdominal infection and in addition received anti-microbial therapy. Thirty-one patients were treated with latamoxef, 33 with ceftazidime, 20 with ceftriaxone, 47 with imipenem/cilastatin, and 109 with a combination of aminoglycosides and clindamycin (control group). The indications for surgery included: post operative peritonitis; gall bladder empyema; perforated gastroduodenal ulcer; perforation of the small intestine with or without ileus; perforated appendicitis; perforation of the colon. On average, treatment with latamoxef amounted to 12 days, with ceftazidime: 9.4 days, with ceftriaxone 8.4 days and with imipenem/cilastatin 6.7 days. The clinical success occurred in 84% of those treated with latamoxef, 79% for ceftazidime, 50% for ceftriaxone and 81% for imipenem/cilastatin. The rate of clinical success for patients treated with an aminoglycoside/clindamycin combination was 58%. The effectiveness of the beta-lactam antibiotics studied was at least equal to that of the aminoglycoside/clindamycin combination. The beta-lactam antibiotics had the advantage of a simpler clinical application, unlike treatment with aminoglycosides, where serum level monitoring is necessary. These clinical results were not as a rule improved upon following an extension of the period of treatment by one week.