Effectiveness of ceftriaxone versus cefoxitin in reducing chest and wound infections after upper abdominal operations.
A controlled randomized trial with blind assessment of end results is described comparing the efficacy of 1 g of intravenous ceftriaxone at induction of anesthesia with 1 g of intravenous cefoxitin (three times) administered every 8 hours starting at induction in preventing pulmonary and wound infection after upper abdominal operations. There were 150 adults who underwent biliary or gastroduodenal operations who were randomized to each protocol. A total of 123 patients completed the protocol--59 received ceftriaxone and 64 cefoxitin. Chest infection was defined as pyrexia plus clinical and/or radiologic signs of consolidation or the production of purulent sputum. Wound infection was defined as purulent wound discharge. There was a significant reduction (19% versus 42%, P < 0.05) in chest complications and in wound infection (0% versus 8%, P < 0.05) in the ceftriaxone group compared with the cefoxitin group. It is concluded that for biliary and gastroduodenal operations, 1 g of ceftriaxone is superior to 1 g of cefoxitin (three times) administered every 8 hours and that this effect is likely to be due to the prolonged bactericidal blood levels produced by a single dose of ceftriaxone.
Morris
W T
WT
Department of Surgery University of Auckland, New Zealand.
D001662:Biliary Tract Surgical Procedures; D002440:Cefoxitin / Q000008:administration & dosage / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000008:administration & dosage / Q000627:therapeutic use*; D003365:Costs and Cost Analysis; D004334:Drug Administration Schedule; D004386:Duodenum / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011292:Premedication; D012141:Respiratory Tract Infections / Q000517:prevention & control*; D013270:Stomach / Q000601:surgery; D013530:Surgical Wound Infection / Q000517:prevention & control*
D002440:Cefoxitin; D002443:Ceftriaxone