Cefoxitin versus erythromycin, neomycin, and cefazolin in colorectal operations. Importance of the duration of the surgical procedure.
Perioperative parenteral cefoxitin was compared with oral erythromycin, neomycin and parenteral cefazolin in a prospective, double-blind, randomized evaluation of 119 patients undergoing colorectal operations. Patients receiving cefoxitin had a higher wound infection rate than patients receiving erythromycin-neomycin-cefazolin (12.5% v 3.2%, respectively, p = .06). A direct correlation existed between the duration of the operation and the infection rate. Cefoxitin prophylaxis was as effective as erythromycin-neomycin-cefazolin in patients undergoing surgical procedures of 4 hours or less (infection rates of 4.8% and 4.0%, respectively). However, for surgical procedures lasting more than 4 hours, 5 of 14 patients (37.5%) receiving cefoxitin developed a wound infection v 0 of 13 patients receiving erythromycin-neomycin-cefazolin (p less than .05). It is speculative as to whether frequent two-gram doses of cefoxitin given during the operation would provide prophylaxis equivalent to erythromycin-neomycin-cefazolin.
D002437:Cefazolin / Q000627:therapeutic use*; D002440:Cefoxitin / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003106:Colon / Q000601:surgery*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004917:Erythromycin / Q000627:therapeutic use*; D006801:Humans; D009355:Neomycin / Q000627:therapeutic use*; D011446:Prospective Studies; D011897:Random Allocation; D012007:Rectum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control; D013997:Time Factors
D004917:Erythromycin; D002440:Cefoxitin; D009355:Neomycin; D002437:Cefazolin