[Sulbactam/ampicillin in comparison with cefuroxime for infections of the lower respiratory tract. Results of a prospective, randomized comparative study].

In a randomized prospective study, ampicillin (AMP) in combination with the beta-lactamase-inhibitor, sulbactam (SBT) was compared with cefuroxime (CXM) in 73 hospitalized patients with lower respiratory tract infections. 36 patients received SBT/AMP 1 g/2 g t.i.d. and 37 patients received CXM 1.5 g t.i.d.--both in the form of i.v. infusion. The duration of treatment ranged from five to twelve days, with a median of eight days in each group. 23 patients (64%) of the SBT/AMP group had pneumonia, while 13 (36%) had acute purulent bronchitis; 13 of the patients (36%) received artificial respiration. 23 patients (62%) of the CXM group had pneumonia and 14 (38%) acute purulent bronchitis; eight patients (22%) required artificial respiration. In 54 patients (SBT/AMP: 26; CXM: 28) initial culture yielded bacterial pathogens, mainly Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, Staphylococcus aureus and pneumococci. 35 patients in each group were clinically evaluable. 31 patients (89%) responded to treatment with SBT/AMP, and 28 patients (80%) to treatment with CXM. Four patients (11%) who received SBT/AMP failed to respond, as did seven patients on CXM. The bacteriological efficacy was assessed in 26 patients of the SBT/AMP group: in 22 cases (84%) baseline pathogens were eradicated, while in two patients (8%) each, there was persistent infection and a superinfection, respectively. In 23 patients (82%) of the CXM group (28 patients evaluated) the pathogens were eradicated, while three cases (11%) had persistent infection, and two (7%) superinfection. Apart from a case of exanthema under CXM, no adverse drug reactions were reported. No statistically significant differences were to be seen between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)