***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: ABSTRACT The pharmacokinetics of ertapenem and ceftriaxone were investigated in an open , r and omized , two-period crossover study after single- and multiple-dose administration in 10 healthy volunteers ( five women and five men ) . Both antibiotics were administered intravenously once daily for 7 days at dosages of 1 g ( ertapenem ) and 2 g ( ceftriaxone ) . The concentrations of the antibiotics in serum and urine were quantified by the agar well diffusion method bioassay and , in addition , for ertapenem only , by liquid chromatography coupled with t and em mass spectrometry ( LC-MS/MS ) . For ertapenem the maximum concentration of the drug in plasma ( Cmax ) was 256 mg/liter , the half-life was 20.7 h , and the area under the plasma concentration-time curve ( AUC ) was 830 mg · h/liter . The concentrations in fecal sample s were ( mean value ) 37.2 and 32.7 mg/kg on day 4 and day 8 , respectively . Ceftriaxone exhibited a mean Cmax of 315 mg/liter , a half-life of 7.6 h , and an AUC of 1,556 mg · h/liter . The mean concentrations in fecal sample s were 153 and 258 mg/kg on day 4 and day 8 , respectively . No accumulation of ertapenem or ceftriaxone was detected at steady state . A slightly but significantly decreased AUC for ertapenem was detected for the female volunteers . No serious adverse event was observed . Both antibiotics induced a marked decrease in the anaerobic microflora ( 4-log-unit decreases in lactobacilli , bifidobacteria , clostridia , and bacteroides ) and Escherichia coli , whereas the number of enterococci increased ( 4 log units ) . A slight overgrowth of yeasts was observed with both regimens . In all cases the microflora returned to normal levels on days 21 to 35 In a double-blind , multicenter trial , 541 febrile granulocytopenic patients were r and omized to receive either intravenous ( iv ) clinafloxacin ( 200 mg every 12 h ) or i.v . imipenem ( 500 mg every 6 h ) as empirical monotherapy . More baseline pathogens were susceptible to clinafloxacin ( 259 [ 99 % ] of 262 organisms ) than to imipenem ( 253 [ 95 % ] of 265 ; P=.03 ) . Initial favorable clinical response rates for clinafloxacin ( 88 [ 32 % ] of 272 patients ) and imipenem ( 89 [ 33 % ] of 269 ) were similar . After addition of other antimicrobial agents , overall response rates were 259 ( 95 % ) of 272 for clinafloxacin and 251 ( 93 % ) of 269 for imipenem . During the study , only 13 clinafloxacin ( 5 % ) and 18 imipenem ( 7 % ) recipients died . Both drugs were generally well tolerated . Drug-related skin rash occurred more often with clinafloxacin ( 11 % vs. 6 % ; P=.07 ) , whereas nausea ( 2 % vs. 5 % ; P=.16 ) , Clostridium-difficile-associated diarrhea ( 3 % vs. 8 % ; P=.02 ) , and seizures ( 0 % vs. 2 % ; P=.06 ) occurred more often with imipenem . These results suggest that clinafloxacin and imipenem have similar efficacy as empirical monotherapy in febrile granulocytopenic patients To compare efficacy and safety of a tigecycline regimen with an imipenem/cilastatin regimen in hospital-acquired pneumonia patients , a phase 3 , multicenter , r and omized , double-blind , study evaluated 945 patients . Co primary end points were clinical response in clinical ly evaluable ( CE ) and clinical modified intent-to-treat ( c-mITT ) population s at test-of-cure . Cure rates were 67.9 % for tigecycline and 78.2 % for imipenem ( CE patients ) and 62.7 % and 67.6 % ( c-mITT patients ) , respectively . A statistical interaction occurred between ventilator-associated pneumonia ( VAP ) and non-VAP subgroups , with significantly lower cure rates in tigecycline VAP patients compared to imipenem ; in non-VAP patients , tigecycline was noninferior to imipenem . Overall mortality did not differ between the tigecycline ( 14.1 % ) and imipenem regimens ( 12.2 % ) , although more deaths occurred in VAP patients treated with tigecycline than imipenem . Overall , the tigecycline regimen was noninferior to the imipenem/cilastatin regimen for the c-mITT but not the CE population ; this difference appears to have been driven by results in VAP patients OBJECTIVE : To compare the efficacies of cefepime and ceftazidime as empiric therapy during the management of fever in cancer patients with chemotherapy-induced neutropenia . METHODS : A prospect i ve , double-blind , r and omized study of cefepime 2 g every eight hours and ceftazidime 2 g every eight hours was performed in 276 adult neutropenic ( absolute neutrophil count < 500/mm3 ) cancer patients with fever . RESULTS : Median duration of neutropenia was five days . Sixty-one percent ( n = 188 ) of the patients were evaluable . Treatment was successful in 57 % ( 58/101 ) of cefepime-treated patients and 60 % ( 52/87 ) of ceftazidime-treated patients ( 95 % CI −18 to 12 ; p = 0.77 ) . Bacteremic clearance occurred in 71 % ( 12/17 ) of cefepime-treated patients and 40 % ( 6/15 ) of ceftazidime-treated patients ( p = 0.3 ) . Both drugs were well tolerated . CONCLUSIONS : Cefepime appears to be as effective as ceftazidime in the initial treatment of febrile episodes in adult cancer patients with chemotherapy-associated neutropenia of modest duration BACKGROUND Gemifloxacin is an enhanced-affinity quinolone with potent activity against lower respiratory tract pathogens . OBJECTIVE The efficacy and safety of a 5-day course of gemifloxacin were compared with those of a st and ard 7-day regimen of clarithromycin in patients with an acute exacerbation of chronic bronchitis ( AECB ) . The impact of treatment on the long-term ( 26 weeks ) clinical outcome was also assessed . METHODS The acute phase of this r and omized , double-blind study was performed in 93 centers in 7 countries . Adult patients ( age > 40 years ) with a history of chronic bronchitis and an Anthonisen type 1 acute exacerbation ( increased dyspnea , cough , and sputum purulence ) were eligible . Patients receiving systemic steroids at a dose of > 10 mg prednisone or the equivalent were excluded . Patients were r and omized to receive gemifloxacin 320 mg once daily for 5 days or clarithromycin 500 mg twice daily for 7 days . Clinical and bacteriologic response rates were assessed at the end-of-therapy visit ( days 8 - 12 ) , the week 2 - 3 follow-up visit ( days 13 - 24 ) , and the week 4 - 5 follow-up visit ( days 25 - 38 ) . The long-term phase ( 26 weeks ) , which included US and Canadian participants only , evaluated the proportion of patients who remained free of a recurrence of AECB requiring additional antimicrobial  therapy after resolution of the initial episode . RESULTS Seven hundred twelve patients were r and omized to treatment , 351 to gemifloxacin and 361 to clarithromycin .  The long-term study included 438 patients , 214 receiving gemifloxacin and 224 receiving clarithromycin .  Clinical success rates at the 2 - 3 week follow-up visit were 85.4 % for gemifloxacin and 84.6 % for clarithromycin .  Bacteriologic success rates were 86.7 % for gemifloxacin and 73.1 % for clarithromycin . Significantly more patients receiving gemifloxacin than clarithromycin remained free of AECB recurrences ( 71.0 % vs 58.5 % , respectively ; P = 0.016 ) . Both treatments were well tolerated . CONCLUSIONS In the acute treatment of Anthonisen type 1 AECB , a 5-day course of gemifloxacin was at least as effective as a 7-day regimen of clarithromycin . In this population , significantly more patients receiving gemifloxacin remained free of AECB recurrence after 26 weeks compared with those receiving clarithromycin A prospect i ve , r and omized study was undertaken to compare the efficacy and safety of tobramycin and ceftazidime in the treatment of serious infections in 77 urological patients . Of the 39 tobramycin-treated and 38 ceftazidime-treated patients , 74 % and 82 % , respectively , were cured clinical ly . Microbiological cure rates were 72 % and 79 % , respectively . Three patients treated with tobramycin and two treated with ceftazidime developed a significant superinfection . Both drugs were tolerated well . Because of potential ototoxicity and nephrotoxicity the use of aminoglycosides is less advantageous than ceftazidime for seriously infected urological patients Ora ; ciprofloxacin was studied as a prophylactic antimicrobial agent in high- and low-risk patients undergoing endoscopic retro grade cholangiography .  Ciprofloxacin appeared to be effective , good serum levels were attained , and the drug compared favourably on grounds of cost and convenience with a parenterally-administered cephalosporin The efficacy of clindamycin and phenoxymethylpenicillin in the treatment of orofacial infections was compared in a r and omised study in 60 patients : 30 patients received clindamycin 150 mg every 6 h for seven days , and 30 received phenoxymethylpenicillin 1 g every 12 h for seven days . Where indicated incision and drainage were carried out . All patients but one in each group responded satisfactorily to treatment . Although the clindamycin group had a shorter duration of pain , swelling and fever and more favourable laboratory findings , the differences between the groups were not statistically significant . Of the 60 microbiological specimens 23 yielded only anaerobic bacteria , 34 both anaerobic and aerobic bacteria , two aerobic bacteria only and one no growth . In the penicillin group one case of severe diarrhoea occurred , and six patients in the clindamycin group had moderate to severe gastrointestinal discomfort , including one case ofClostridium difficile associated diarrhoea . This difference was however not statistically significant . The results support the continued use of penicillin for treatment of orofacial infections , with clindamycin serving as an effective alternative This pooled analysis includes 2 phase 3 , double-blind trials design ed to evaluate the safety and efficacy of tigecycline , versus that of imipenem-cilastatin , in 1642 adults with complicated intra-abdominal infections . Patients were r and omized to receive either tigecycline ( initial dose of 100 mg , followed by 50 mg intravenously every 12 h ) or imipenem-cilastatin ( 500/500 mg intravenously every 6 h ) for 5 - 14 days . The primary end point was the clinical response at the test-of-cure visit ( 12 - 42 days after therapy ) in the co- primary end point microbiologically evaluable and microbiological modified intent-to-treat population s. For the microbiologically evaluable group , clinical cure rates were 86.1 % ( 441/512 ) for tigecycline , versus 86.2 % ( 442/513 ) for imipenem-cilastatin ( 95 % confidence interval for the difference , -4.5 % to 4.4 % ; P < .0001 for noninferiority ) . Clinical cure rates in the microbiological modified intent-to-treat population were 80.2 % ( 506/631 ) for tigecycline , versus 81.5 % ( 514/631 ) for imipenem-cilastatin ( 95 % confidence interval for the difference , -5.8 % to 3.2 % ; P < .0001 for noninferiority ) . Nausea ( 24.4 % tigecycline , 19.0 % imipenem-cilastatin [ P = .0 
    Output:
    
In conclusion , data from RCTs showed that clindamycin and carbapenems were associated with more CDIs than other antibiotics