Cefminox versus Metronidazole plus Gentamicin in Intra-abdominal Infections: A Prospective Randomized Controlled Clinical Trial

Summary

Background: The aim of this prospective study was to compare the safety and efficacy of a new cephamycin, cefminox 2 g/12 h, to those of the usual regimen combining metronidazole 500 mg/8 h and gentamicin 80 mg/8 h (M+G).

Patients and Methods: 160 patients with clinically proven intra-abdominal infection were prospectively included in an open parallel randomized comparative multicenter trial. Antibiotics were started preoperatively and discontinued after clinical and laboratory evidence of resolution of the infection. Serum and peritoneal fluid levels and serum bactericidal activities were also studied.

Results: 150 patients were clinically evaluable. There was one failure in the cefminox group and three in the M+G group (not significant, RR: 1.07, 95% CI: 1–1.15). No differences were found in the number of wound infections, length of stay or duration of antibiotic therapy. Adverse effects were reported in 11 cases, all of them mild to moderate. Escheria coli and Bacteroides fragilis were the most frequently found microorganisms.

Conclusion: Cefminox is as effective and as safe as M+G in the treatment of intra-abdominal infections.