SUPERIORIDADE DA ASSOCIACAO AZTREONAM/CLINDAMICINA EM COMPARACAO A GENTAMICINA/CLINDAMICINA EM PACIENTES COM TRAUMA ABDOMINAL PENETRANTE

Translated title of the contribution: Superiority of aztreonam/clindamycin compared with gentamicin/clindamycin in patients with penetrating abdominal trauma

Timothy Fabian, M. M. Hess, Martin Croce, R. S. Wilson, S. E. Wilson, S. L. Charland, J. H. Rodman, Bradley Boucher

Research output: Contribution to journalArticle

Abstract

There were 73 evaluable patients entered into a prospective, double-blinded trial comparing aztreonam/clindamycin (A/C) to gentamicin/clindamycin (G/C) for the prevention of infection after penetrating abdominal trauma. Aztreonam was administered at a dosage of 2 g every 8 hours and gentamicin at 5 mg/kg for the first 24 hours and then adjusted by serum monitoring to a peak of 6 to 8 μg/mL and a trough of less than 2 μg/mL: all patients received 900 mg of clindamycin every 8 hours. Patients with colon wounds received 4 days of antibiotics, and the remaining patients received a 24-hour course. Gunshot wounds occurred in 69% of patients: 74% of all patients had some hollow viscus injury, and 26% had only solid viscus injury. The groups were well matched according to abdominal trauma index, percentage with colon injury, and transfusion requirements. Failures occurred in eight patients (11%): two wound infections, five intra-abdominal infections, and one case of necrotizing fasciitis. Seven infections occurred in 36 (19%) G/C patients compared with 1 in 37 (3%) A/C patients (p < 0.03). The hospital stay was 12 ± 11 days for G/C patients and 8 ± 7 for A/C patients (p < 0.12). The superiority of the A/C regimen may be partially attributable to relative underdosing of gentamicin (approximately half of the patients had inadequate levels after 24 hours) combined with a favorable pharmacokinetic profile (significantly prolonged half-life) of aztreonam in this clinical setting.

Original languagePortuguese
Pages (from-to)269-275
Number of pages7
JournalArquivos Brasileiros de Medicina
Volume69
Issue number5
StatePublished - Jan 1 1995

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Aztreonam
Clindamycin
Gentamicins
Wounds and Injuries
Viscera
Colon
Intraabdominal Infections
Necrotizing Fasciitis
Gunshot Wounds
Wound Infection
Infection
Half-Life
Length of Stay

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

SUPERIORIDADE DA ASSOCIACAO AZTREONAM/CLINDAMICINA EM COMPARACAO A GENTAMICINA/CLINDAMICINA EM PACIENTES COM TRAUMA ABDOMINAL PENETRANTE. / Fabian, Timothy; Hess, M. M.; Croce, Martin; Wilson, R. S.; Wilson, S. E.; Charland, S. L.; Rodman, J. H.; Boucher, Bradley.

In: Arquivos Brasileiros de Medicina, Vol. 69, No. 5, 01.01.1995, p. 269-275.

Research output: Contribution to journalArticle

Fabian, Timothy ; Hess, M. M. ; Croce, Martin ; Wilson, R. S. ; Wilson, S. E. ; Charland, S. L. ; Rodman, J. H. ; Boucher, Bradley. / SUPERIORIDADE DA ASSOCIACAO AZTREONAM/CLINDAMICINA EM COMPARACAO A GENTAMICINA/CLINDAMICINA EM PACIENTES COM TRAUMA ABDOMINAL PENETRANTE. In: Arquivos Brasileiros de Medicina. 1995 ; Vol. 69, No. 5. pp. 269-275.
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