PIPERACILLIN IN SURGICAL INFECTIONS: A CLINICAL TRIAL

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Abstract
Piperacillin was administered in 18 patients with mixed infections. Three had osteomyelitis, 2 had peritonitis, 2 had gangrenous toes, 1 had bronchopneumonia and 10 had leg ulcers of various types accompanied by cellulitis. In 11 patients, 1 of the infecting organisms was Pseudomonas aeruginosa, and another had P. maltophilia. All had appropriate surgical treatment, which in 9 patients included skin grafting in the presence of P. aeruginosa. All the patients were clinically cured except for 1 with osteomyelitis who relapsed and was found to have a residual sequestrum. None of the skin grafts failed. In other patients who underwent grafting, cloxacillin was also given because she had a .beta.-lactamase-producing staphylococcus. The only adverse reaction was thrombophlebitis of the vein used for drug administration in 15 out of 18 patients. Other isolates of P. aeruginosa (105) were tested in the laboratory against piperacillin, and resistance to the drug was rare. Piperacillin is a safe drug to use, is effective against a wide range of organisms and is particularly effective in preventing the destruction of skin grafts by P. aeruginosa. It is likely to be ineffective against .beta.-lactamase-producing staphylococci; when these are present another drug such as cloxacillin should also be used.

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