Single-dose antibiotic prophylaxis of abdominal surgical wound infection: a trial of preoperative latamoxef against peroperative tetracycline lavage.
A randomized controlled clinical trial was undertaken in 542 consecutive emergency and elective abdominal operations, with one group of patients receiving tetracycline peritoneal and wound lavage and the other a single intravenous injection of 1 g latamoxef at induction of anaesthesia. Seventy-five patients were withdrawn because no potentially contaminated hollow viscus was opened, and a further 36 because they could not be assessed for wound infection. Of the remaining 431 patients, 212 received latamoxef resulting in 5 major and 8 minor wound infections in hospital; another 4 minor infections occurred at home (total incidence 8.0%). In the tetracycline group (n = 219) there were 7 major and 19 minor wound infections in hospital and 10 minor infections later (total incidence 16.4%). This is significantly higher than the rate with latamoxef (P = 0.012). Monitoring of operative and postoperative bleeding revealed no evidence (except in one doubtful case) of excessive bleeding associated with the use of a single dose of latamoxef. It is concluded that single-dose preoperative latamoxef is more effective than peroperative tetracycline lavage for the prevention of wound infections after potentially contaminated abdominal operations.
D000009:Abdominal Muscles / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005260:Female; D005334:Fever / Q000150:complications; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D009070:Moxalactam / Q000627:therapeutic use*; D011292:Premedication; D011897:Random Allocation; D013210:Staphylococcus / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D013752:Tetracycline / Q000627:therapeutic use*; D007507:Therapeutic Irrigation
D013752:Tetracycline; D009070:Moxalactam