A comparison of the roles of cefamandole and ceftriaxone in abdominal surgery.
In a prospective, randomized study, we compared the ability of ceftriaxone sodium (serum half-life, 8.0 hours) and cefamandole naftate and sodium carbonate (serum half-life, 0.8 hours) to prevent wound infection in 1238 patients undergoing abdominal surgery. Prophylaxis consisted of single-dose therapy at the time of induction of anesthesia, and treatment regimens contained ceftriaxone sodium, 1 g/d intravenously, or cefamandole naftate and sodium carbonate, 1 g intravenously every 6 hours. Except for low-risk biliary procedures, cephalosporin therapy was accompanied by the administration of metronidazole. No significant difference was noted in the incidence of wound infection, ie, 5.6% for the ceftriaxone group (95% confidence interval, 3.8% to 7.4%) and 6.9% for the cefamandole group (95% confidence interval, 4.9% to 8.9%). Single-dose prophylaxis with 1 g of cefamandole naftate and sodium carbonate was relatively inexpensive and provided a cost savings of 64%. When treatment was required, a 23% cost savings was associated with the use of a once-daily dose of 1 g of ceftriaxone sodium.
Hall
J C
JC
Department of Surgery, Royal Perth Hospital, Australia.
Hall
J L
JL
Christiansen
K
K
D000005:Abdomen / Q000601:surgery*; D000293:Adolescent; D000368:Aged; D002435:Cefamandole / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011292:Premedication; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*
D002435:Cefamandole; D002443:Ceftriaxone