Ceftriaxone vs. ampicillin + metronidazole as prophylaxis against infections after clean-contaminated abdominal surgery.
In a prospective, controlled, double-blind study, 496 patients undergoing abdominal surgery were given antibiotic prophylaxis with a single dose of either ceftriaxone or ampicillin + metronidazole. No significant intergroup difference was found between the respective overall rates of infectious complications (3.2% and 4.9%). Analysis of the microbiologic findings showed incisional wound infections, mainly caused by gram-negative rods, to be more common in the ampicillin-metronidazole group, whereas deep wound infections were more frequent in the ceftriaxone group. It is concluded that ceftriaxone seems to be more efficient than ampicillin-metronidazole as prophylaxis against incisional wound infection, but should preferably be supplemented with an antianaerobic agent to prevent deep wound infections.
Luke
M
M
Department of Surgery, Sundby Hospital, Copenhagen, Denmark.
Iversen
J
J
Søndergaard
J
J
Kvist
E
E
Lund
P
P
Andersen
F
F
Naver
L
L
Larsen
P N
PN
Clausen
B
B
Prag
J
J
D000005:Abdomen / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000008:administration & dosage / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000517:prevention & control; D002443:Ceftriaxone / Q000627:therapeutic use*; D013505:Digestive System Surgical Procedures; D004311:Double-Blind Method; D004338:Drug Combinations; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010538:Peritonitis / Q000517:prevention & control; D011446:Prospective Studies; D018805:Sepsis / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000517:prevention & control*
D004338:Drug Combinations; D008795:Metronidazole; D002443:Ceftriaxone; D000667:Ampicillin