Randomized trial of imipenem-cilastatin versus gentamicin plus clindamycin in the treatment of polymicrobial infections.

The comparative efficacy of imipenem-cilastatin versus clindamycin and gentamicin in the treatment of polymicrobial infections was evaluated. Eleven patients completed treatment with the former and nine with the latter. Conditions treated included infected extremity ulcers, peritonitis, perirectal abscess, soft-tissue abscess, abdominal abscess, and acute diverticulitis. Similar rates of bacteriologic and clinical cure or improvement were achieved with the two treatments. Superinfection occurred in two patients who received imipenem-cilastatin and one who received clindamycin and gentamicin. No significant difference in adverse effects was noted. Imipenem-cilastatin appears to be an effective antibiotic in treating polymicrobial infections; however, a much larger patient population would be required to detect a significant difference in the efficacy rates or frequency of adverse effects when comparing the two regimens.