Randomized, double-blind comparison of cefotaxime, cefoxitin, cefazolin or placebo as prophylaxis during gastric, small bowel or complicated biliary surgery.
In a double-blinded trial, 142 patients were randomized to receive placebo, cefazolin, cefoxitin or cefotaxime during high-risk gastroduodenal, biliary tract or small bowel surgery. Of the 125 evaluable patient trials, postoperative wound infection or intra-abdominal sepsis developed in 14/29 (48%) of placebo controls, 8/24 (33%) cefazolin, 7/37 (19%) cefoxitin, and in 2/35 (6%) of cefotaxime recipients. When patients undergoing vagotomy and pyloroplasty with prior cimetidine therapy were excluded, cefotaxime was superior to cefoxitin prophylaxis (2/26 versus 7/28, P = 0.014). Cefotaxime may be useful as a prophylactic agent in high-risk upper gastrointestinal surgery.
D000328:Adult; D000368:Aged; D001662:Biliary Tract Surgical Procedures; D002437:Cefazolin / Q000627:therapeutic use; D002439:Cefotaxime / Q000627:therapeutic use; D002440:Cefoxitin / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D013505:Digestive System Surgical Procedures; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011292:Premedication; D011897:Random Allocation; D013270:Stomach / Q000601:surgery; D014628:Vagotomy
D002511:Cephalosporins; D002440:Cefoxitin; D002437:Cefazolin; D002439:Cefotaxime