TY - JOUR T1 - PRospective randomized comparison of mezlocillin therapy alone with combined ampicillin and gentamicin therapy for patients with cholangitis AU - Gerecht WB, Henry NK, Hoffman WW, et al Y1 - 1989/06/01 N1 - 10.1001/archinte.1989.00390060033007 JO - Archives of Internal Medicine SP - 1279 EP - 1284 VL - 149 IS - 6 N2 - • Forty-six patients with cholangitis were randomized to receive therapy with mezlocillin sodium (24 patients) or a combination of ampicillin sodium—gentamicin sulfate (22 patients). The biliary concentration of mezlocillin was 112 times higher than that of ampicillin and 778 times higher than that of gentamicin. The ratio of the concentration in serum or bile over the minimum inhibitory concentration against aerobic gram-negative bacilli (therapeutic index) was higher for mezlocillin than for either ampicillin or gentamicin. Twenty (83%) of 24 patients were cured following mezlocillin therapy compared with 9 (41%) of 22 patients after ampicillin-gentamicin therapy. The 3 patients with superinfection were in the ampicillin-gentamicin arm of the study. Fewer toxic or adverse effects occurred in association with mezlocillin treatment than with ampicillin-gentamicin treatment. Mezlocillin therapy was more effective, less toxic, and less expensive than treatment with ampicillin and gentamicin for patients with cholangitis.(Arch Intern Med. 1989;149:1279-1284) SN - 0003-9926 M3 - doi: 10.1001/archinte.1989.00390060033007 UR - http://dx.doi.org/10.1001/archinte.1989.00390060033007 ER -