Journal Article

Once-Daily Intravenous Cefazolin Plus Oral Probenecid Is Equivalent to Once-Daily Intravenous Ceftriaxone Plus Oral Placebo for the Treatment of Moderate-to-Severe Cellulitis in Adults

M. Lindsay Grayson, Malcolm McDonald, Kimberley Gibson, Eugene Athan, Wendy J. Munckhof, Phillip Paull and Fran Chambers

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 11, pages 1440-1448
Published in print June 2002 | ISSN: 1058-4838
Published online June 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/340056
Once-Daily Intravenous Cefazolin Plus Oral Probenecid Is Equivalent to Once-Daily Intravenous Ceftriaxone Plus Oral Placebo for the Treatment of Moderate-to-Severe Cellulitis in Adults

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A once-daily regimen of cefazolin (2 g intravenously [iv]) plus probenecid (1 g by mouth) was compared with a once-daily regimen of ceftriaxone (1 g iv) plus oral placebo in a randomized, double-blind equivalence trial of home-based therapy for moderate-to-severe cellulitis in adults. For the assessable recipients of cefazolin-probenecid (n = 59) and ceftriaxone-placebo (n = 57), clinical cure occurred at the end of treatment in 86% and 96% (P = .11), respectively, and was maintained at 1 month of follow-up in 96% and 91% (P = .55), respectively. The mean number of treatment doses (±standard deviation) given was similar in the 2 treatment arms (6.97 ± 2.6 for cefazolin-probenecid and 6.12 ± 2.1 for ceftriaxone-placebo; P = .06). The median antibiotic trough concentrations were 2.35 μg/mL for cefazolin and 15.45 μg/mL for ceftriaxone. Patients in the 2 treatment arms were similar with regard to overall rates of adverse reaction (P = .15), but nausea was more common among those in the cefazolin-probenecid arm (P = .048). The once-daily regimen of cefazolin-probenecid is a cheap, practical, and effective treatment option for moderate-to-severe cellulitis, and it avoids the need to use third-generation cephalosporins in most patients.

Journal Article.  4130 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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