Ampicillin/sulbactam compared with cefotaxime in the treatment of lower respiratory tract infections of bacterial etiology.

This was a randomized, prospective, parallel study of the efficacy and safety of ampicillin/sulbactam (2 g/1 g) and cefotaxime (2 g), administered intravenously every 6 hours, in 53 hospitalized patients with lower respiratory tract infections. Thirty-four of the 36 patients treated with ampicillin/sulbactam and 16 of the 17 patients treated with cefotaxime were evaluable. Clinical and bacteriologic effectiveness did not differ significantly between the two groups (P = .828, P = .648, respectively). Of the ampicillin/sulbactam-treated patients, 21 (61.8%) were cured, 8 (23.5%) were improved, and 4 (11.8%) were treatment failures. In the cefotaxime group, 9 patients (56.3%) were cured, 4 (25%) were improved, and 2 (12.5%) were treatment failures. All primary pathogens were eradicated in 19 (55.9%) ampicillin/sulbactam-treated patients and partially eradicated in 7 (20.6%); in cefotaxime-treated patients, all primary pathogens were eradicated in 10 (62.5%) patients and partially eradicated in 2 (12.5%). Both study drugs were well tolerated, with the overall incidence of adverse events similarly low in the two groups.