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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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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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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
2002
Overview
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.
Publisher
The University of Chicago Press,University of Chicago Press
Subject
/ Adult
/ Aged
/ Antibiotics. Antiinfectious agents. Antiparasitic agents
/ Bacterial diseases of the skin
/ Biological and medical sciences
/ Ceftriaxone - adverse effects
/ Ceftriaxone - therapeutic use
/ Cephalosporins - adverse effects
/ Cephalosporins - therapeutic use
/ Dosage
/ Female
/ Humans
/ Male
/ Nausea
/ Pharmacology. Drug treatments
/ Placebos
/ Probenecid - adverse effects
/ Probenecid - therapeutic use
