Smith J A, Forward A D, Skidmore A G, Bell G A, Murphy J M, Sutherland E
Surgery. 1983 Jan;93(1 Pt 2):217-20.
A study of antibiotic treatment of intra-abdominal sepsis was conducted between May 1978 and May 1981. In the first phase, clindamycin (C) was compared with metronidazole (M), each combined with tobramycin (T), in a prospective, double-blind, randomized study. Twenty-three patients received C + T and 34 patients received M + T. The two groups were similar with respect to age, gender, underlying disease, presence of abscess, clinical condition, severity of illness, duration of illness before treatment and bacteriology. Anaerobic organisms outnumbered facultative and aerobic organisms. Bacteroides fragilis and Escherichia coli predominated. In the C + T group of patients, 74% had a good response. In the M + T group, 83% had good results. Adverse effects were few and minor in the two treatment groups. Three patients on C + T and one who received M + T followed by C + T died of infections; two patients died of underlying disease. In the second, open phase of the study, M + T was used to treat 45 patients with 46 courses. Twenty patients had intra-abdominal abscesses, which represented all grades of severity of illness. Five patients received long-term corticosteroid therapy. Almost half the patients had peritonitis complicating appendicitis. Good results were obtained in 81%. One patient died of the underlying disease and one died of infection complicating severe trauma and hypovolemic shock.
1978年5月至1981年5月期间进行了一项关于腹腔内脓毒症抗生素治疗的研究。在第一阶段，在一项前瞻性、双盲、随机研究中，将克林霉素（C）与甲硝唑（M）分别与妥布霉素（T）联合使用进行比较。23例患者接受C + T治疗，34例患者接受M + T治疗。两组在年龄、性别、基础疾病、脓肿存在情况、临床状况、疾病严重程度、治疗前病程和细菌学方面相似。厌氧菌数量超过兼性菌和好氧菌。脆弱拟杆菌和大肠杆菌占主导。在接受C + T治疗的患者组中，74%有良好反应。在M + T组中，83%有良好结果。两个治疗组的不良反应少且轻微。3例接受C + T治疗的患者和1例接受M + T后改为C + T治疗的患者死于感染；2例患者死于基础疾病。在研究的第二阶段即开放阶段，M + T用于治疗45例患者共46个疗程。20例患者有腹腔内脓肿，代表了所有严重程度的疾病。5例患者接受长期皮质类固醇治疗。几乎一半的患者患有并发阑尾炎的腹膜炎。81%取得了良好结果。1例患者死于基础疾病，1例死于并发严重创伤和低血容量性休克的感染。
