All issues > Volume 29(1); 1986

Original Article

J Korean Pediatr Soc. 1986;29(1):1-17. Published online January 31, 1986.

A Comparative study of Sulbactam/Ampicillin vs Ampicillin/Amikacin in infections of the Pediatric Age Group.

Keun Soo Lee¹, Ha Baik Lee¹, Seon Ock Khang¹, Jung Hee Lee¹, Tai Yeal Choi², Choon Won Kim²

¹Department of Pediatrics, College of Medicine , Hanyang University
²Department of Clinical Pathology, College of Medicine , Hanyang University

Abstract

Sulbactam has been shown to be an irreversible inhibitor of bacterial beta.lactamase. The spectrum of Ampicillin is extended hen it is used in combination with Sulbactam to cover Ampicillin resistant organisms. The safety and efficacy of Sulbactamj Ampicillin vs. Ampicillin/Amikacin are compared in the treatment of various disease in pediatric age group Patients are assigned randomly to receive either Sulbactam/ Ampicillin or Ampicillin Amikacin. In each group, 50 mg/kg of Sulbactam and 100 mg/kg of Ampicillin in a 1: 2 ratio as given by intravenous or intramuscular injection in 3-4 divided doses every 6-8 hours while 100 mg!kg of Ampicillin and 15-20 mg/kg Amikacin was given by intravenous or intramuscular injection in 4 and 2 divided doses, respectively. The mean duration of hospitalization for the Sulbactamj Ampicillin-treated group was 7. 2 ±l. 8days ranging from 4 to 12 days and that of Ampicillinj Amikacin-teated group as 7.1 ±2.0days ranging from 4 to 14 days. The summary of the results from the study and the observation is as follows: 1) The in-vitro sensitivity test of Sulbactamj Ampicillin revealed high sensitivity results for Staphylococcus aureus, 97.7%; Enterococci, 100% and thcse were much higher compared with that of Ampicillin alone. And the in-vitro sensitivity test of Sulbactamj Ampicillin also revealed high sensitivity results for Klebsiella pneumoniae, 69.4%, Klebsiella cxytoca 100%; Escherichia coli, 52.8% and for most of the Gram negative organisms. 2) Sulbactamj Ampicillin showed low or poor sensitivity results for Pseudomonas species and Serratia marcescens. 3) Ampicillin showed low or poor sensitivity results for most of the Gram positive and Gram negative bacteria except Citrobacter freundii(72.7%). Amikacin showed high sensitivity results for most of the Gram positive and Gram negative organisms. 4) The safety and efficacy of Sulbactamj Ampicillin vs. Ampiciilin/Amikacin are compared in the treatment of various infectious disease in pediatric age group. Satisfactory clinical responses were observed in 94.0% of Sulbactamj Ampicillin-treated group and 100% in Ampicillin/Amikacin-treated group. Pathogen were eradicated from 31 in 35 bacteriologically proved patients treated with Sulbactam/Ampicillin and from all (25 in 25) patients treated with Ampicillin/ Amikacin. 5) Clinically no severe adverse reactions have been noted in Sulbactamj Arr..picillin-treated group except transitorily increased transaminase in 3 cases and transitory eosinophilia in 9cases. On the hole the authors conclude from the laboratory and the clinical study that Sulbactamj Ampicillin carries broad spectrum sensitivity and also high sensitivity for certain bactenae strains observed and is as effective as Ampicillinj Amikacin in the treatment of various infectious disease in pediatric age group.

Keywords :Disc sensitivity test; Comparative study of Sulbactam /Ampicillin vs. Ampicillin/Amikacin; Pediatric field