Ampicillin plus mecillinam vs. cefotaxime/cefadroxil treatment of patients with severe pneumonia or pyelonephritis: a double-blind multicentre study evaluated by intention-to-treat analysis

Scandinavian Journal of Infectious Diseases
S CronbergR Neringer

Abstract

In this double-blind multicentre study, using the intention-to-treat approach, a total of 293 patients with fever (> or = 38.5 degrees C), symptoms of sepsis and signs of pneumonia or pyelonephritis were randomly assigned to treatment with ampicillin and mecillinam (A+M) or cefotaxime followed by cefadroxil. In the febrile phase, treatment was given intravenously twice daily, either with 1,200 mg ampicillin together with 600 mg mecillinam or with 2 g cefotaxime alone. When the patients stayed afebrile, the intravenous administration was replaced by oral treatment twice daily for 14 days, either with 500 mg pivampicillin and 400 mg pivmecillinam or 1 g cefadroxil. In the A+M group, 33% (48/144) of the patients did not complete the full course of treatment as compared with 32% (47/149) in the cephalosporin group, the reasons being treatment failure in 27 and 29, respectively, or adverse effects (n = 16 in both groups). The median duration of fever was 47 h in the A + M group and 50 h in the cephalosporin group. Of 135 patients with pneumonia, 68% were completely cured in the A + M group, and 65% in the cephalosporin group, the main reasons for treatment failure being Mycoplasma pneumonia or ornithosis. Of 136 patients with pyelon...Continue Reading

References

Jul 1, 1977·The Journal of Antimicrobial Chemotherapy·B G Spratt
May 1, 1990·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·T SandbergL G Nilsson

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Citations

Jul 21, 2006·International Journal of Antimicrobial Agents·Giorgina B PiccoliG Piccoli
Jan 1, 1997·Scandinavian Journal of Infectious Diseases·T SandbergA M Olinder-Nielsen
Jul 27, 2007·Scandinavian Journal of Infectious Diseases·Lindsay E Nicolle, Michael R Mulvey
May 22, 2018·Open Forum Infectious Diseases·Jesse D SuttonEmily S Spivak
Sep 30, 2020·The Journal of Antimicrobial Chemotherapy·Jonas Bredtoft BoelBarbara Juliane Holzknecht

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