Antibiotic prophylaxis in high risk biliary surgery: one dose of ceftriaxone compared with two doses of cefuroxime.
In a controlled trial 219 high risk patients undergoing biliary surgery were allocated at random by sealed envelopes to one of two treatment groups. Group I (n = 112) received a single dose ceftriaxone 1 g intravenously at the time of skin incision, and group II (n = 107) was given cefuroxime 1.5 g intravenously at the time of skin incision, followed by a second dose eight hours later. There were no significant differences between groups in age, sex, diagnosis, or operations carried out. There were three wound infections in group I (3%) and four in group II (4%) (p = 0.65). One patient in group I and two patients in group II developed intra-abdominal abscess and septicaemia (0.9% and 1.9%, respectively). Five patients developed pneumonia postoperatively in group I (5%) and six in group II (6%) (p = 0.65). There was no significant difference of the total number of postoperative infectious complications (wound infection, intraabdominal abscess, septicaemia, and pneumonia) between the groups (p = 0.42). A single dose of ceftriaxone given intravenously at skin incision was as effective as two doses of cefuroxime for the prophylaxis of wound infection in this high risk group of patients.
Department of Surgical Gastroenterology F, Bispebjerg Hospital, Copenhagen, Denmark.
A
A
Hjortrup
F
F
Moesgaard
F
F
Jensen
C
C
Johansen
R
R
Nielsen
D000038:Abscess / Q000453:epidemiology; D002443:Ceftriaxone / Q000008:administration & dosage*; D002444:Cefuroxime / Q000008:administration & dosage*; D002763:Cholecystectomy / Q000009:adverse effects*; D002764:Cholecystitis / Q000601:surgery*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology; D011292:Premedication; D018805:Sepsis / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*
D002443:Ceftriaxone; D002444:Cefuroxime