Ampicillin-sulbactam versus cefoxitin for prophylaxis in high-risk patients undergoing abdominal surgery.
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.
Paladino
J A
JA
Clinical Pharmacokinetics Laboratory, Millard Fillmore Hospital, Williamsville, NY.
Rainstein
M A
MA
Serrianne
D J
DJ
Przylucki
J E
JE
Welage
L S
LS
Collura
M L
ML
Schentag
J J
JJ
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*
C035444:sultamicillin; D002440:Cefoxitin; D000667:Ampicillin; D013407:Sulbactam