Ertapenem versus ceftriaxone and metronidazole as treatment for complicated intra-abdominal infections

Narcisco S. Navarro, Maria I. Campos, Ramon Alvarado, Nora Quintero, Frank J. Branicki, Junmin Wei, Malathi Shivaprakash, France Vrijens, Hilde Giezek, Christina Y. Chan, Mark J. DiNubile

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24 Citations (Scopus)


Background: Prompt surgical intervention supplemented by appropriate antimicrobial therapy is usually required for successful treatment of complicated intra-abdominal infections. The objective of this study was to further evaluate the efficacy and safety of ertapenem relative to ceftriaxone/metronidazole as treatment for complicated intra-abdominal infections. Methods: Adult patients with intra-abdominal infections requiring surgery were eligible for this open-label randomized trial comparing ertapenem 1 g daily with ceftriaxone 2 g daily plus metronidazole 30 mg/kg/day. The primary efficacy outcome was the clinical response rate in clinically and microbiologically evaluable participants at the test-of-cure (TOC) visit 2 weeks after discontinuation of therapy. All treated patients were included in the safety analysis. Results: Participant demographics, disease characteristics, and duration of therapy in both treatment groups were generally similar. Escherichia coli was the most commonly isolated baseline pathogen, recovered in 52% of cases in each treatment group. Favorable clinical responses were achieved at TOC in 143 (96.6%) of 148 ertapenem recipients and in 146 (96.7%) of 151 ceftriaxone/metronidazole recipients. The frequencies of drug-related adverse events, most commonly nausea, diarrhea, vomiting, and elevated platelet count, were generally comparable in both treatment arms. Four ertapenem recipients (1.8%) and one ceftriaxone/metronidazole recipient (0.4%) experienced serious drug-related adverse events. Conclusions: In this study, ertapenem and ceftriaxone/metronidazole were comparably effective treatments for adult patients with complicated intra-abdominal infections.

Original languageEnglish
Pages (from-to)25-34
Number of pages10
JournalInternational Journal of Surgery
Issue number1
Publication statusPublished - 2005
Externally publishedYes


  • Ceftriaxone
  • Ertapenem
  • Intra-abdominal infection
  • Metronidazole

ASJC Scopus subject areas

  • General Medicine


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