Oral ciprofloxacin versus intravenous cefuroxime as prophylaxis against postoperative infection in vascular surgery: a randomised double-blind, prospective multicentre study.
OBJECTIVE
To test the hypothesis that oral ciprofloxacin is equally effective as intravenous cefuroxime in preventing postoperative infectious complications in patients undergoing peripheral arterial surgery involving the groins.


METHODS
Prospective, randomised, double-blind multicentre study.


METHODS
580 patients undergoing arterial surgery involving the groins were randomised to ciprofloxacin (Ciproxin, Bayer) 750 mg x 2 p.o. or cefuroxime (Zinacef, Glaxo) 1.5 g x 3 i.v. given only on the day of surgery. The primary endpoint was wound/graft infection within 30 days postoperatively. Wound infection was defined as pus.


RESULTS
The wound infection rate in the ciprofloxacin group was 9.2% (27 patients) and in the cefuroxime group 9.1% (26 patients) according to intention to treat. For correct treatment the corresponding numbers were 9.5% (23 patients) and 9.7% (22 patients), respectively. There were three graft infections (0.5%). The infection rate was 7.1% (31/433) in the absence and 14.9% (22/147) in the presence of distal ulcers (p < 0.05). S. allreus was the most common bacteria isolated. Forty percent of the wound infections were localised to the groins. By multivariate analysis presence of distal ulcer was the only factor of prognostic significance.


CONCLUSIONS
The infection rate was similar in the two groups. Thus, oral administration of ciprofloxacin is an attractive, cost-effective and safe alternative to prophylaxis in vascular patients capable of taking oral medication on the day of surgery.
Risberg
B
B
Department of Surgery, Malmö General Hospital, Lund University, Sweden.
Drott
C
C
Dalman
P
P
Holm
J
J
Ivarsson
L
L
Jivegård
L
L
Karlström
L
L
Odén
A
A
Pedersen
P
P
Rahm
V
V
D000284:Administration, Oral; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods* / Q000706:statistics & numerical data; D016010:Binomial Distribution; D002444:Cefuroxime / Q000008:administration & dosage*; D002511:Cephalosporins / Q000008:administration & dosage*; D002939:Ciprofloxacin / Q000008:administration & dosage*; D004311:Double-Blind Method; D006801:Humans; D007262:Infusions, Intravenous; D016015:Logistic Models; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D013548:Sweden / Q000453:epidemiology; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data
D000890:Anti-Infective Agents; D002511:Cephalosporins; D002939:Ciprofloxacin; D002444:Cefuroxime