guideline.gov

http://guideline.gov/content.aspx?id=25586&search=ampicillin+sulbactam

http://guideline.gov/content.aspx?id=12210&search=ampicillin+sulbactam

Copyright © 1997 Hindawi Publishing Corporation.

Ampicillin/Sulbactam Vs. Cefoxitin for the Treatment of Pelvic Inflammatory Disease

Joseph G. Jemsek ^1,2 and Frank Harrison¹

¹ Department of Obstetrics and Gynecology, Charlotte Memorial Hospital, Charlotte, NC, USA,

² Nalle Clinic, 1918 Randolph Road, Charlotte, NC, 28207, USA,

Corresponding author.

Received December 27, 1996; Accepted October 28, 1997.

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: The safety and efficacy of ampicillin plus sulbactam were compared with those of cefoxitin in the treatment of women with pelvic inflammatory disease (PID).

Methods: This single-site, randomized, prospective, third-party-blinded, comparative, parallel-treatment study enrolled 93 women with a diagnosis of PID. Patients were treated with either ampicillin/sulbactam (2 g/1 g, administered intravenously [IV], every 6 h) or cefoxitin (2 g, administered IV, every 6 h) for a minimum of 12 doses. Patients with cultures positive for Chlamydia trachomatis also received concurrent oral or IV doxycycline (100 mg twice daily). Patients with cultures negative for C. trachomatis received prophylactic oral doxycycline (100 mg twice daily) for 10-14 days after treatment with either ampicillin/sulbactam or cefoxitin was completed.

Results: Ninety-three patients were entered in the study: 47 in the ampicillin/sulbactam arm and 46 in the cefoxitin arm. All 93 patients were evaluable for safety; 61 (66%) were evaluable for efficacy. Demographic characteristics were similar for the groups. Of the 27 evaluable ampicillin/sulbactam-treated patients, 67% experienced clinical cure, 30% improved, and 4% failed treatment. Respective values for the 34 cefoxitin-treated patients were 68%, 24%, and 9% (P = 0.67). Pathogens were eradicated in 70% of the women given ampicillin/sulbactam vs. 56% of those who received cefoxitin (P = 0.64).

Conclusions: Overall, ampicillin/sulbactam demonstrated clinical and bacteriologic efficacy at least equivalent to that of cefoxitin in the treatment of women with acute PID. The use of ampicillin/sulbactam for this indication may avoid the complex dosing regimens associated with other treatments.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2364580/

ClinicalTrials.gov

Comparison of Ampicillin / Sulbactam vs. Ampicillin / Gentamicin for Treatment of Intrapartum Chorioamnionitis: a Randomized Controlled Trial

This study is currently recruiting participants.

Verified January 2012 by Stanford University

First Received on April 7, 2009.   Last Updated on January 11, 2012

http://clinicaltrials.gov/ct2/show/NCT00879190

Ampicillin/Sulbactam versus Cefuroxime as antimicrobial prophylaxis for cesarean delivery: a randomized study

Eleftherios Ziogos1^†, Sotirios Tsiodras2^†, Ioannis Matalliotakis1, Helen Giamarellou2and Kyriaki Kanellakopoulou2^*

• *Corresponding author: Kyriaki Kanellakopoulou[email protected]
• † Equal contributors

Author Affiliations

¹Department of Obtsterics and Gynecology, University General Hospital of Heraclion, Heracleion, Greece

²4th Academic Department of Internal Medicine, University of Athens Medical School, Athens, Greece

For all author emails, please log on.

BMC Infectious Diseases 2010, 10:341 doi:10.1186/1471-2334-10-341

The electronic version of this article is the complete one and can be found online at:

http://www.biomedcentral.com/1471-2334/10/341

© 2010 Ziogos et al; licensee BioMed Central Ltd. 

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

The efficacy and safety of a single dose of ampicillin/sulbactam compared to a single dose of cefuroxime at cord clamp for prevention of post-cesarean infectious morbidity has not been assessed.

Methods

Women scheduled for cesarean delivery were randomized to receive a single dose of either 3 g of ampicillin-sulbactam or 1.5 g of cefuroxime intravenously, after umbilical cord clamping. An evaluation for development of postoperative infections and risk factor analysis was performed.

Results

One hundred and seventy-six patients (median age 28 yrs, IQR: 24-32) were enrolled in the study during the period July 2004 - July 2005. Eighty-five (48.3%) received cefuroxime prophylaxis and 91 (51.7%) ampicillin/sulbactam. Postoperative infection developed in 5 of 86 (5.9%) patients that received cefuroxime compared to 8 of 91 (8.8%) patients that received ampicillin/sulbactam (p = 0.6). In univariate analyses 6 or more vaginal examinations prior to the operation (p = 0.004), membrane rupture for more than 6 hours (p = 0.08) and blood loss greater than 500 ml (p = 0.018) were associated with developing a postoperative surgical site infection (SSI). In logistic regression having 6 or more vaginal examinations was the most significant risk factor for a postoperative SSI (OR 6.8, 95% CI: 1.4-33.4, p = 0.019). Regular prenatal follow-up was associated with a protective effect (OR 0.04, 95% CI: 0.005-0.36, p = 0.004).

Conclusions

Ampicillin/sulbactam was as safe and effective as cefuroxime when administered for the prevention of infections following cesarean delivery.

http://www.biomedcentral.com/1471-2334/10/341