Clinafloxacin versus Piperacillin-Tazobactam in Treatment of Patients with Severe Skin and Soft Tissue Infections

G Siami; N Christou; I Eiseman; K. J Tack; Clinafloxacin Severe Skin and Soft Tissue Infection Study Group

doi:10.1128/AAC.45.2.525-531.2001

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Clinafloxacin versus Piperacillin-Tazobactam in Treatment of Patients with Severe Skin and Soft Tissue Infections

Journal article

Open access

Peer reviewed

Clinafloxacin versus Piperacillin-Tazobactam in Treatment of Patients with Severe Skin and Soft Tissue Infections

G Siami, N Christou, I Eiseman, K. J Tack and Clinafloxacin Severe Skin and Soft Tissue Infection Study Group

Antimicrobial agents and chemotherapy, Vol.45(2), pp.525-531

02/01/2001

DOI: 10.1128/AAC.45.2.525-531.2001

PMCID: PMC90322

PMID: 11158750

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Abstract

Patients (n = 409) with severe skin and soft tissue infections (SSTIs) were randomized to receive clinafloxacin or piperacillin-tazobactam (plus optional vancomycin for methicillin-resistant cocci), administered intravenously, with the option to switch to oral medication. Most patients had cellulitis, wound infections, or diabetic foot infections. Staphylococcus aureus, Enterococcus faecalis, and Pseudomonas aeruginosa were the most common baseline pathogens. Fewer baseline pathogens were resistant to clinafloxacin (1.8%) than to piperacillin-tazobactam (6.2%) (P = 0.001). The clinafloxacin and piperacillin-tazobactam groups did not differ significantly in clinical cure rates (68.8 and 65.2%, respectively) or microbiologic eradication rates (61.5 and 57.2%). Clinafloxacin yielded higher eradication rates for all three of the most common pathogenic species, although no differences were statistically significant. Within the power of this study, the overall frequency of adverse events was similar (P = 0.577) in the two treatment groups. Drug-associated adverse events (P = 0.050) and treatment discontinuations (P = 0.052) were marginally more frequent in the clinafloxacin group, primarily due to phototoxicity in outpatients receiving clinafloxacin. Although most cases of phototoxicity were mild to moderate, four cases were reported as severe. In summary, clinafloxacin monotherapy was equivalent in effectiveness to therapy with piperacillin-tazobactam plus optional vancomycin in the treatment of hospitalized patients with severe SSTIs.

Bacterial Infections

Anti-Infective Agents

beta-Lactamase Inhibitors

Clinical Therapeutics

Enzyme Inhibitors

Fluoroquinolones

Penicillanic Acid

Penicillins

Piperacillin

Skin Diseases, Infectious

Details

Title: Subtitle: Clinafloxacin versus Piperacillin-Tazobactam in Treatment of Patients with Severe Skin and Soft Tissue Infections
Creators: G Siami - Vanderbilt University Medical Center
N Christou - McGill University Health Centre
I Eiseman - Parke-Davis
K. J Tack - Parke-Davis
Clinafloxacin Severe Skin and Soft Tissue Infection Study Group
Contributors: D Talan (Contributor) - University of Iowa, Emergency Medicine
Resource Type: Journal article
Publication Details: Antimicrobial agents and chemotherapy, Vol.45(2), pp.525-531
Publisher: American Society for Microbiology
DOI: 10.1128/AAC.45.2.525-531.2001
PMID: 11158750
PMCID: PMC90322
ISSN: 0066-4804
eISSN: 1098-6596
Language: English
Date published: 02/01/2001
Academic Unit: Emergency Medicine; Internal Medicine
Record Identifier: 9984297143702771

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