title: Ampicillin-sulbactam versus cefoxitin for prophylaxis in high-risk patients undergoing abdominal surgery.
abstract: This double-blind study compared ampicillin-sulbactam 3 g versus cefoxitin 2 g in 136 adult patients at risk for developing an infection after abdominal surgery. Separate randomization schedules were used for colorectal, upper gastrointestinal/biliary, and other abdominal procedures. Study antibiotics were administered within 30 minutes before incision and repeated 6 hours later. Patients having colorectal surgery received a third dose of antibiotic 6 hours after the second. Efficacy evaluations were made on 123 patients, 62 in the ampicillin-sulbactam group and 61 in the cefoxitin group. The overall postoperative infection rates were 12.9% for ampicillin-sulbactam and 9.8% for cefoxitin (p > 0.05); one wound infection occurred in each group. Adverse events were experienced by 13.2% of the ampicillin-sulbactam and 19.1% of the cefoxitin recipients (p > 0.05). Cost-minimization analysis revealed that ampicillin-sulbactam was a cost-effective alternative to cefoxitin for the prevention of infection after abdominal surgery.
authors.affiliation: Clinical Pharmacokinetics Laboratory, Millard Fillmore Hospital, Williamsville, NY.
authors.forename: J A
authors.initials: JA
authors.lastname: Paladino
authors.forename: M A
authors.initials: MA
authors.lastname: Rainstein
authors.forename: D J
authors.initials: DJ
authors.lastname: Serrianne
authors.forename: J E
authors.initials: JE
authors.lastname: Przylucki
authors.forename: L S
authors.initials: LS
authors.lastname: Welage
authors.forename: M L
authors.initials: ML
authors.lastname: Collura
authors.forename: J J
authors.initials: JJ
authors.lastname: Schentag
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D000667:Ampicillin / Q000191:economics / Q000627:therapeutic use; D002440:Cefoxitin / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011292:Premedication; D018570:Risk Assessment; D013407:Sulbactam / Q000191:economics / Q000627:therapeutic use; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: C035444:sultamicillin; D002440:Cefoxitin; D000667:Ampicillin; D013407:Sulbactam