Peri-operative antibiotic cover in amputations using an amoxycillin-clavulanic acid combination.
In a series of 64 patients requiring amputation for lower limb sepsis, the performance of a new antibiotic combination with beta-lactamase-inhibiting properties, amoxycillin plus clavulanic acid (A-CA) (Augmentin; Beecham) in the prophylaxis of postoperative wound sepsis, was compared with that of a combination of amoxycillin and ampicillin (A-A) (Suprapen; Bencard) and a control group. The sepsis rate following A-CA prophylaxis (12,9%) was significantly less than in the control group (x 2 = 18, 49; P less than 0,001). Although not attaining statistical significance (x 2 = 2, 12),, A-CA compared favourably with A-A (sepsis rate 35.3%) in the prevention of post-amputation wound sepsis. There was no statistically significant difference in the development of sepsis between wounds closed primarily and those left unsatured while under A-CA cover. It is concluded that peri-operative antibiotic cover for amputations in septic lower limb lesions is advisable and that A-CA is a valuable antibiotic in this situation.
D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage* / Q000627:therapeutic use; D000667:Ampicillin / Q000627:therapeutic use; D000672:Amputation Stumps; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D019818:Clavulanic Acid; D004338:Drug Combinations; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D007769:Lactams / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D014946:Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D007769:Lactams; D019818:Clavulanic Acid; D000667:Ampicillin; D000658:Amoxicillin