@entity2891 compared with @entity869 plus XXXX for severe biliary tract infections.

@entity1 @entity295 @entity2890 @entity3885 @entity253 @entity869 @entity2891
In a prospective, randomized, multicenter study, the efficacy and safety of @entity2891 and the combination @entity869 - @entity2890 as initial therapy for @entity1 with severe acute biliary tract infections were compared. Of 77 @entity1 initially entered in the study, definite severe @entity253 was confirmed in 67. Sixty-four @entity1 completed treatment. At the end of treatment, 35 of 36 (97%) @entity1 given @entity2891 and 23 of 28 (82%) given @entity869 - @entity2890 were cured of their infection (P = 0.07). Pathogens were recovered from the bile in 32 @entity1 ; microbiological cures were observed in 18 of 19 (94%) @entity1 receiving @entity2891 and 8 of 13 (62%) receiving @entity869 - @entity2890 (P = 0.03). Thirteen @entity1 had @entity295 . None (0%) of the eight septicemic @entity1 from the @entity2891 group, but two of five (40%) from the @entity869 - @entity2890 group, were clinical failures. Of the isolated pathogens, 51% were resistant to @entity869 , while the resistance rate was 4% for @entity2890 and 1% for @entity2891 (P less than 0.001). Biliary concentrations of @entity2891 were maintained at high levels--236 +/- 87 micrograms/ml up to 12 h after administration. Even in the presence of severe @entity3885 , @entity2891 levels in the bile and gallbladder wall were above MICs for most pathogens. @entity2891 may be considered as an excellent alternative in the therapy of severe biliary tract infections.
