Multicentered study of cefoperazone for treatment of intraabdominal infections and comparison of cefoperazone with cefamandole and clindamycin plus gentamicin for treatment of appendicitis and peritonitis.

Cefoperazone was evaluated for efficacy and safety in the treatment of known or suspected intraabdominal infections. Initially, 59 patients were enrolled in an open, noncomparative study. Of the 35 patients in whom the efficacy of treatment could be evaluated, 32 had a satisfactory clinical response. In this open study, cefoperazone eradicated 62 of 71 pathogens. The safety of the drug was evaluated in all 59 patients. Adverse reactions were seen in nine patients. In the second part of the study, 144 patients were enrolled. Fifty-seven of these patients received cefoperazone, 35 received cefamandole, and 52 received clindamycin plus gentamicin. Therapeutic efficacy could be evaluated in 20 patients who received cefoperazone, 20 who received cefamandole, and 16 who received clindamycin-gentamicin. Satisfactory clinical responses were seen in 90%, 80%, and 100% of these patients, respectively; satisfactory bacteriologic responses were seen in 100%, 95%, and 100%, respectively. A 5% incidence of adverse reactions was observed among the 57 patients who received cefoperazone; in contrast, the rate of adverse reaction to cefamandole was 11%, and that to clindamycin-gentamicin was 11.5%. No differences were seen among the patients in the three groups. Thus, cefoperazone appears to be safe and effective for the treatment of intraabdominal infections of bacterial etiology.