Combination antibiotic treatment does not result in less organ failure in adults with severe sepsis

May 21, 2012, JAMA and Archives Journals

Frank M. Brunkhorst, M.D., of Friedrich-Schiller University, Jena, Germany, and colleagues conducted a study to compare the effect of the antibiotics moxifloxacin and meropenem with the effect of meropenem monotherapy on sepsis-related organ dysfunction. Early appropriate antimicrobial therapy leads to lower mortality rates associated with severe sepsis. The authors hypothesized that maximizing the potential benefit and appropriateness of initial antibiotics by using 2 antibiotics would improve clinical outcomes compared with monotherapy.

The trial included 298 patients who fulfilled usual criteria for severe sepsis or who were randomized to receive monotherapy, and 302 to receive combination therapy. The trial was performed in 44 intensive care units in Germany from October 2007 to March 2010, and the number of evaluable patients was 273 in the monotherapy group and 278 in the combination therapy group. The intervention was recommended for 7 days and up to maximum of 14 days after randomization or until discharge from the intensive care units or death, whichever occurred first.

Among 551 evaluable patients, there was no statistically significant difference in average Sequential Organ Failure Assessment (SOFA; degree of organ failure) score between the meropenem and moxifloxacin group and the meropenem alone group. "The rates for 28-day and 90-day mortality also were not statistically significantly different. By day 28, there were 66 deaths (23.9 percent) in the combination therapy group compared with 59 deaths (21.9 percent) in the monotherapy group. By day 90, there were 96 deaths (35.3 percent) in the combination therapy group compared with 84 deaths (32.1 percent) in the monotherapy group," the authors write.

"In conclusion, in this randomized multicenter trial of adult patients with severe sepsis or septic shock, empirical treatment with the combination of meropenem and moxifloxacin compared with meropenem alone did not result in less ."

Explore further: Fever control using external cooling reduces early mortality in septic shock patients

More information: JAMA, doi:10.1001/JAMA. 2012.5833

Related Stories

Fever control using external cooling reduces early mortality in septic shock patients

February 17, 2012
Fever control using external cooling in sedated patients with septic shock is safe and decreases vasopressor requirements and early mortality, according to a new study from researchers in France.

Recommended for you

Nanoparticle vaccine offers universal protection against influenza A viruses, study finds

January 24, 2018
Researchers have developed a universal vaccine to combat influenza A viruses that produces long-lasting immunity in mice and protects them against the limitations of seasonal flu vaccines, according to a study led by Georgia ...

Leprosy's drug resistance and origin revealed by genome analysis

January 24, 2018
Leprosy is an infectious disease with gruesome symptoms. It damages the skin, peripheral nerves, the upper respiratory tract, and the eyes. Despite being curable with multidrug therapy, leprosy still persists in many developing ...

A new theory on reducing cardiovascular disease risk in binge drinkers

January 23, 2018
A new study shows that binge drinkers have increased levels of a biomarker molecule—microRNA-21—that may contribute to poor vascular function.

Flu infection study increases understanding of natural immunity

January 23, 2018
People with higher levels of antibodies against the stem portion of the influenza virus hemagglutinin (HA) protein have less viral shedding when they get the flu, but do not have fewer or less severe signs of illness, according ...

New long-acting approach for malaria therapy developed

January 22, 2018
A new study, published in Nature Communications, conducted by the University of Liverpool and the Johns Hopkins University School of Medicine highlights a new 'long acting' medicine for the prevention of malaria.

Virus shown to be likely cause of mystery polio-like illness

January 22, 2018
A major review by UNSW researchers has identified strong evidence that a virus called Enterovirus D68 is the cause of a mystery polio-like illness that has paralysed children in the US, Canada and Europe.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.