A prospective comparison of two regimens of prophylactic antibiotics in abdominal trauma: cefoxitin versus triple drug.
To determine the best antibiotic regimen to employ in patients undergoing laparotomy for trauma, a randomized prospective study was designed comparing cefoxitin alone with a triple-drug regime of an aminoglycoside, ampicillin, and clindamycin. One hundred nineteen consecutive patients sustaining abdominal trauma (97 penetrating; 22 blunt) were divided by date of admission to a 24-hour course of antibiotics. The overall infection rate was 16.0%, with 14.5% of the cefoxitin-treated patients, and 18.0% of the triple-drug-treated patients developing an infectious complication. Excluding remote site infections, the abdominal wound and intraperitoneal infection rates were 13.0% for cefoxitin-treated patients, and 12.0% for triple-drug-treated patients. There was one instance of oliguric renal failure questionably related to an aminoglycoside. It is concluded that a 24-hour course of cefoxitin is a safe and effective prophylactic antibiotic regime in patients undergoing laparotomy for trauma.
D000007:Abdominal Injuries / Q000150:complications / Q000601:surgery*; D000328:Adult; D000617:Aminoglycosides / Q000627:therapeutic use*; D000667:Ampicillin / Q000627:therapeutic use*; D002440:Cefoxitin / Q000627:therapeutic use*; D002981:Clindamycin / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011897:Random Allocation; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*
D000617:Aminoglycosides; D002981:Clindamycin; D002440:Cefoxitin; D000667:Ampicillin