[Single-dose ceftriaxone versus multiple-dose cefuroxime for prophylaxis of surgical site infection].
OBJECTIVE
To compare the effects and pharmacoeconomics of single-dose of ceftriaxone versus 3-day cefuroxime prophylaxis in patients undergoing gastric or colorectal resection.


METHODS
Three hundred and five consecutive patients with gastric or colorectal cancer from 5 medical centers were randomly divided into ceftriaxone group (n = 153, receiving intravenously 1 g ceftriaxone 0.5 - 1 h prior to operation only) and cefuroxime group (n = 152, receiving 0.75 g cefuroxime preoperatively and the same dose q8h for 3 d). The patients' intra- and postoperative status, adverse responses and infectious complications were observed and documented, and pharmacoeconomic parameters were analyzed.


RESULTS
The disease distribution, operative procedures and patients' conditions in the 2 groups were comparable. No adverse responses to the test antibiotics were observed. Postoperative infectious complications occurred in 7 cases in the ceftriaxone group (4.58%) and 14 cases in the cefuroxime group (9.21%), respectively (P = 0.992), among which, 12 cases were surgical site infections (incisional, intra-abdominal): 2 cases in the ceftriaxone group (1.31%), and 10 cases in the cefuroxime group (6.58%), (chi(2) = 5.607, P = 0.018). The direct cost related to prevention and treatment of surgical site infections was 283.5 RMB in the ceftriaxone group and 811.1 RMB in the cefuroxime group (Z = 14.51, P = 0.000).


CONCLUSIONS
Both ceftriaxone and cefuroxime are safe and effective for prevention of surgical site infections. Single-dose ceftriaxone prophylaxis is sufficient for gastric and colorectal operations, with a better cost-effectiveness ratio.
Li
Zhan-liang
ZL
Department of General Surgery, 304th Hospital of People's Liberation Army, Beijing 100037, China.
Tong
Sai-xiong
SX
Yu
Bao-ming
BM
Tang
Wei-song
WS
Wu
Zhi-yong
ZY
Wang
Shi-bin
SB
Wu
Yu-fei
YF
Lu
Wei-qi
WQ
Luo
Meng
M
Wang
Jian
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000191:economics*; D002443:Ceftriaxone / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D002444:Cefuroxime / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D002444:Cefuroxime