Prophylactic antibiotics for elective colorectal surgery or operation for obstruction of the small bowel: a comparison of cefonicid and cefoxitin.
Elective colorectal surgery carries a rate of septic complications of up to 35% in patients not receiving prophylaxis. This can be reduced to 5% in patients receiving appropriate prophylactic agents. The safety and efficacy of cefonicid, a new cephalosporin with a half-life of 4-5 hr, were compared with those of cefoxitin for prophylaxis in patients undergoing elective colorectal procedures or surgery for obstruction of the small bowel. Fifty-seven assessable patients were randomly assigned in a double-blind fashion to therapy with 1 g of cefonicid intravenously (iv) or intramuscularly (im) 1 hr before surgery only or 2 g of cefoxitin iv or im 1 hr before surgery and 2 g every 6 hr for 24 hr. Groups were comparable in terms of underlying diseases. Samples for blood culture were obtained immediately before and after surgery and at 8:00 A.M. on the first and second postoperative days. No blood cultures were positive. Two of 30 patients receiving cefonicid developed wound infections (6%). Two of 27 patients receiving cefoxitin developed wound infections, and one developed an intraabdominal abscess (11%). No significant adverse effects were noted. The results suggest cefonicid may be an effective prophylactic antibiotic for bowel surgery. Most importantly, cefonicid offers the advantages associated with the administration of a single daily dosage, among which are reduction of pharmacy costs and the freeing of nursing hours for patient care.
D000328:Adult; D000368:Aged; D002435:Cefamandole / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015790:Cefonicid; D002440:Cefoxitin / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003108:Colonic Diseases / Q000601:surgery*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011292:Premedication; D011446:Prospective Studies; D011897:Random Allocation; D012002:Rectal Diseases / Q000601:surgery*; D013530:Surgical Wound Infection / Q000517:prevention & control*
D002435:Cefamandole; D015790:Cefonicid; D002440:Cefoxitin