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Intravenous fleroxacin, 400 mg once a day, was compared with ceftazidime, 0.5-2 g three times a day or 1-2 g twice a day, for the treatment of skin and skin structure infections. Duration of treatment was 4-21 days. The study was a multicenter, unblinded comparison. Of the 316 patients enrolled, 212 were randomized to treatment with fleroxacin and 104 to ceftazidime (2:1 ratio); 92 fleroxacin-treated patients and 50 ceftazidime-treated patients were included in the standard analysis of efficacy. The most common diagnoses were wound infections and cellulitis, which affected 36% and 30% of the fleroxacin group, and 24% and 24% of the ceftazidime group, respectively. In the fleroxacin group, 82% of the infecting organisms were eradicated, and in the ceftazidime group, 79%. The overall rates of bacteriologic cure, by infection, were 79% for the fleroxacin group and 74% for the ceftazidime group, and those for clinical cure were 82% and 73%, respectively. It could not be concluded with 95% confidence that the two regimens resulted in equivalent cure rates because the range of between-group differences was outside the stipulated limits of [plus or minus] 15%. The percentage of patients with one or more adverse events was approximately twice as high (17% vs. 9%) in the fleroxacin group than in the ceftazidime group. The most frequent event in both groups was nausea. In this study, intravenous therapy with fleroxacin or ceftazidime produced similar bacteriologic and clinical cure rates, but the statistical requirements permitting a conclusion of equivalence at protocol levels were not met.

The safety and effectiveness of treatment of bacterial infections of the skin and skin structures with fluoroquinolone antibiotics were assessed in 492 patients. Patients received either temafloxacin or ciprofloxacin, and the outcomes of the two treatments were compared. Temafloxacin and ciprofloxacin are members of a new group of antibiotics known as fluoroquinolones. These antibiotics have been shown to kill a wide range of bacteria and to work very efficiently in the body, with minimal adverse effects. Most of the skin infections in this study were superficial skin infections and abscesses usually caused by the bacteria staphylococci. The rate of clinical improvement was 96 percent in those treated with temafloxacin and 99 percent in those treated with ciprofloxacin. The rate of bacterial eradication was 95 percent in those treated with temafloxacin and 93 percent in those treated with ciprofloxacin. The patients experienced very few problems taking the drugs. These results demonstrate that temafloxacin is a safe and effective treatment for bacterial infections of the skin and skin structures. (Consumer Summary produced by Reliance Medical Information, Inc.)

To assess the frequency of transient bacteremia among women undergoing transabdominal and transcervical chorionic villus sampling (CVS).

OBJECTIVE:Our purpose was to evaluate the efficacy of amoxicillin as an alternative therapy to erythromycin for the treatment of cervical chlamydial infections during pregnancy. STUDY DESIGN:A randomized, prospective trial of two treatment regimens for Chlamydia trachomatiswas performed in a cohort of pregnant women enrolled for care in an inner-city, university-based prenatal clinic, with an alternate-therapy crossover arm for primary treatment failures. Pregnant women diagnosed with chlamydial infection by McCoy cell culture of cervical swabs were assigned to receive either 500 mg of amoxicillin three times daily or 500 mg of erythromycin four times daily for 7 days. Patients' partners were treated with doxycycline. Compliance information was obtained by a standardized questionnaire at a posttherapy follow-up visit. Patients with positive follow-up cultures were crossed over into the alternate treatment arm and recultured at a later visit. RESULTS:During the study period 74 women consented to participate in this trial; 36 were treated with amoxicillin and 38 with erythromycin. Initial cure rates of 82.3% (28/34) for the amoxicillin group and 84.6% (27/32) for erythromycin were obtained before crossover (p= 0.91); four patients in each group were lost to follow-up. Overall cure rates after crossover were 84.6% (33/39) for amoxicillin and 84.2% (32/38) for erythromycin (p= 0.83). In the amoxicillin group 12.8% of patients reported side effects compared with 31.6% treated with erythromycin (p= 0.09), although seven erythromycin-treated patients compared with none of those in the amoxicillin arm stopped therapy because of side effects (p= 0.02). CONCLUSION:Amoxicillin offers a reasonable alternative to erythromycin for the treatment of Chlamydia trachomatisin pregnancy, on the basis of both cure rates and patient compliance. (AMJ OBSTETGYNECOL1994;170:829-32.)