Stellato T A, Danziger L H, Hau T, Gauderer M W, Ferron J L, Gordon N
Department of Surgery, University Hospitals of Cleveland, OH 44106.
Arch Surg. 1988 Jun;123(6):714-7. doi: 10.1001/archsurg.1988.01400300060009.
One hundred five patients with peritonitis were randomized to receive either tobramycin sulfate plus clindamycin phosphate or moxalactam alone before surgical intervention. Fifty-nine patients were evaluable. A mean of 3.1 (moxalactam) and 3.5 (tobramycin-clindamycin) pathogens per patient were identified. Overall success rate was 85% (tobramycin-clindamycin, 24/30; moxalactam, 26/29). When patients with appendicitis were excluded, there was an observed but not statistically significant advantage of moxalactam over tobramycin-clindamycin (85% vs 67%). There were five deaths (tobramycin-clindamycin, four; moxalactam, one). Other complications included hypoprothrombinemia (tobramycin-clindamycin, five; moxalactam, five), renal dysfunction (tobramycin-clindamycin, three; moxalactam, one), and superinfection (tobramycin-clindamycin, nine; moxalactam, six). More wound infections were noted in the group given tobramycin-clindamycin. These data suggest that moxalactam is as safe and efficacious as tobramycin plus clindamycin. The observed benefits of this agent warrant study in a larger sample to verify advantages of moxalactam over combination therapy.
105例腹膜炎患者在手术干预前被随机分为两组，分别接受硫酸妥布霉素加磷酸克林霉素治疗或单独接受拉氧头孢治疗。59例患者可进行评估。每位患者平均检出3.1种（拉氧头孢组）和3.5种（妥布霉素 - 克林霉素组）病原体。总体成功率为85%（妥布霉素 - 克林霉素组，24/30；拉氧头孢组，26/29）。排除阑尾炎患者后，观察到拉氧头孢相对于妥布霉素 - 克林霉素有优势，但无统计学意义（85%对67%）。有5例死亡（妥布霉素 - 克林霉素组4例；拉氧头孢组1例）。其他并发症包括低凝血酶原血症（妥布霉素 - 克林霉素组5例；拉氧头孢组5例）、肾功能不全（妥布霉素 - 克林霉素组3例；拉氧头孢组1例）和二重感染（妥布霉素 - 克林霉素组9例；拉氧头孢组6例）。接受妥布霉素 - 克林霉素治疗的组中伤口感染更多。这些数据表明拉氧头孢与妥布霉素加克林霉素一样安全有效。该药物观察到的益处值得在更大样本中进行研究，以验证拉氧头孢相对于联合治疗的优势。
