title: Prospective randomized study comparing amoxicillin-clavulanic acid with cefazolin as antimicrobial prophylaxis in laparotomic gynecologic surgery.
abstract: BACKGROUND
  To compare amoxicillin-clavulanic acid with cefazolin as ultra-short-term prophylaxis in laparotomic gynecologic surgery.
  
  
  METHODS
  A prospective randomized study was conducted to compare two antimicrobial regimens in surgical prophylaxis of laparotomic surgery. Patients were randomly allocated to receive amoxicillin-clavulanic acid (2.2 g) [Group A] or cefazolin (2 g) [Group B] as a single dose 30 min before surgery. Each patient was assessed daily until discharge to evidence febrile status and the presence of infections at the operative site, urinary tract, and respiratory tract.
  
  
  RESULTS
  In the amoxicillin-clavulanic acid (Group A) and cefazolin (Group B) groups, overall 346 and 352 patients, respectively, were evaluable for prophylactic efficacy at hospital discharge. Infectious complications were infrequent in both arms. Febrile morbidity occurred in 21 (6.1%) and 26 (7.4%) patients, respectively, in the amoxicillin-clavulanic acid and cefazolin groups. Wound infection and urinary tract infection were also higher, but not significantly in the cefazolin group (0.5% vs. 1.1% and 2.0% vs. 2.5%, respectively). There was one respiratory tract infection (0.2%) in Group B, and no septic death in either groups.
  
  
  CONCLUSIONS
  Ultra-short-term prophylaxis with both amoxicillin-clavulanic acid and cefazolin is safe in elective laparotomic gynecologic surgery.
authors: Sezione di Ginecologia A, Dipartimento di Scienze Chirurgiche Generali e Specialistiche, Università degli Studi di Bari, Italy. n.cormio@gynecology2.uniba.it
authors: Gennaro
authors: G
authors: Cormio
authors: Franco
authors: F
authors: Di Fazio
authors: Cinzia
authors: C
authors: Cacciapuoti
authors: Stefano
authors: S
authors: Bettocchi
authors: Luisella
authors: L
authors: Borraccino
authors: Luigi
authors: L
authors: Selvaggi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D002437:Cefazolin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000601:surgery; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D019980:Amoxicillin-Potassium Clavulanate Combination; D002437:Cefazolin