Skip to main content
SpringerLink
Log in

Die systemische Mezlocillin-Prophylaxe in der elektiven Kolonchirurgie

Systemic mezlocillin prophylaxis in elective colon surgery

  • Published:
Infection Aims and scope Submit manuscript

Zusammenfassung

In einer prospektiven, randomisierten, kontrollierten Studie mit 100 Patienten wurde die Wirksamkeit prophylaktischer Mezlocillin-Gaben in der elektiven Kolonchirurgie untersucht. 52 Patienten waren in der Behandlungsgruppe, 48 dienten der Kontrolle. Beide Kollektive waren nach Randomisierung in bezug auf Alter, Geschlecht, Erkrankungen und Operationsarten vergleichbar. Präoperativ wurden 2 g Mezlocillin i. v. gegeben, danach 2 g achtstündlich bis zum fünften postoperativen Tag. Bei 20 Patienten wurden die Mezlocillin-Konzentrationen in Serum und Geweben bestimmt und zu den MHK der Kontaminationsflora und der postoperativ isolierten Erreger in Beziehung gesetzt. In der Mezlocillin-Gruppe wurde eine signifikante Senkung der Häufigkeit intraabdominaler Komplikationen, Peritonitiden, Harnwegsinfektionen und Wundinfektionen (10%), verglichen mit der Kontrollgruppe (46%), gefunden. Die durchschnittliche postoperative Liegezeit verkürzte sich signifikant von 23 Tagen in der Kontroll- auf 19 Tage in der Mezlocillin-Gruppe. Die Analyse der bakteriologischen Ergebnisse ergab keinen Anhalt für eine Selektionierung von Keimen durch die systemische Antibiotikaprophylaxe. Es wurden keine Nebenwirkungen im Zusammenhang mit der Mezlocillin-Prophylaxe beobachtet.

Summary

A prospective randomized, controlled study comprising 100 patients was performed to evaluate the effect of mezlocillin given prophylactically in elective colon surgery. Fifty-two patients were treated and 48 served as controls. Both groups were well-matched for age, sex, disease and surgical procedure. 2 g of mezlocillin were given intravenously before surgery and then every eight hours until the fifth postoperative day. The concentrations of mezlocillin in serum and tissues were determined in 20 patients and related to the MICs of the contaminants and the bacteria isolated postoperatively. A significantly lower incidence of intra-abdominal complications, peritonitis, urinary tract infections and wound infections was found in the mezlocillin group (10%) than in the controls (46%). The average number of postoperative hospital days decreased significantly from 23 days in the control group to 19 days in the mezlocillin group. The analysis of the bacteriological results gave no indication of a selection of resistant strains due to the prophylactic use of mezlocillin. No side-effects were found in connection with mezlocillin prophylaxis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Keighley, M. R. B., Crapp, A. R. Preventing infection after gastrointestinal surgery. In:Keighley, M. R. B., Crapp, A. B. (eds.): Topics in gastroenterology. Blackwell, Oxford 1970, pp. 345–366.

    Google Scholar 

  2. Müller, R., Düring, M., Rittmann, W. W. Antibiotikaprophylaxe: Definition und Dokumentation. Helv. Chir. Acta 45 (1978) 427–442.

    Google Scholar 

  3. Keighley, M. R. B., Arabi, Y., Matheson, D., Alexander-Williams, J. Aspect of preventing sepsis in colo-rectal surgery: results of recent clinical trials. J. Antimicrob. Chemother. 4 Suppl. C (1978) 33–38.

    Google Scholar 

  4. Keighley, M. R. B., Burdon, D. W. Gastrointestinal surgery. In:Keighley, M. R. B., Burdon, D. W. (eds.): Antimicrobial prophylaxis in surgery. Pitman Medical Publishing Co., Ltd. Kent, 1979, pp. 81–104.

    Google Scholar 

  5. Keighley, M. R. B. Use of antibiotics (surgical infections). Br. Med. J. I (1978) 1603–1606.

    Google Scholar 

  6. Breyer, H. G., Hussels, H. J., Wenzel, M., Wundschock, M. Zur Problematik der präoperativen Keimreduktion in der Kolonchirurgie. Aktuelle Chirurgie 13 (1978) 393–400.

    Google Scholar 

  7. Kugel, E., Mad, H., Esche, P.-M. Der Einfluß präoperativer Paromomycin-Therapie auf den Wundheilungsverlauf nach Eingriffen am Dickdarm. Fortschr. Med. 97 (1979) 1382–1384.

    Google Scholar 

  8. Wetterfors, J., Höjer, H. Prophylaxis with doxycycline in colorectal surgery. Scand. J. Gastroenterol. 15 Suppl. 59 (1980) 11–16.

    Google Scholar 

  9. Jostarndt, L., Thiede, A., Sonntag, H.-G., Hamelmann, H. Die systemische Antibiotikaprophylaxe in der elektiven Kolonchirurgie. Chirurg 52 (1981) 398–402.

    Google Scholar 

  10. Viddal, K. O., Semb, L. S. Tinidazole and doxycycline compared to doxycycline alone as prophylactic antimicrobial agents in elective colorectal surgery. Scand. J. Gastroenterol. 15 Suppl. 59 (1980) 21–24.

    Google Scholar 

  11. Feathers, R. S., Sagor, G. R., Lewis, A. A. M., Amirak, I. D. Prophylactic systemic antibiotics in colorectal surgery. Lancet II (1977) 4–8.

    Google Scholar 

  12. Slama, T. G., Carey, L. C., Fass, R. J. Comparative efficacy of prophylactic cephalothin and cefamandole for elective colon surgery. Am. J. Surg. 137 (1979) 593–596.

    Google Scholar 

  13. Bach, V. T., Thadepalli, H. Susceptibility of anaerobic bacteriain vitro to 23 antimicrobial agents. Chemotherapy 26 (1980) 344–353.

    Google Scholar 

  14. Bodey, G. P., Pan, T. Mezlocillin:In vitro studies of a new broad spectrum penicillin. Antimicrob. Agents Chemother. 11 (1977) 74–79.

    Google Scholar 

  15. Fass, R. J. In vitro activities of β-lactam and aminoglycoside antibiotics. Arch. Int. Med. 140 (1980) 763–768.

    Google Scholar 

  16. Fu, K. P., Neu, H. C. Azlocillin and mezlocillin: New ureidopenicillins. Antimicrob. Agents Chemother. 13 (1978) 930–938.

    Google Scholar 

  17. Grimm, H. BakteriologischerIn-vitro-Vergleich neuer Penicilline. Berichte über das Internationale Symposium Acylureido-Penicilline, Stuttgart. Verlag für Angewandte Wissenschaften, München 1978, pp. 95–100.

    Google Scholar 

  18. Knothe, H. Die antibakterielle Aktivität von Mezlocillin und Azlocillin. Arzneim.-Forsch./Drug Res. 29 (II) (1979) 1916–1920.

    Google Scholar 

  19. Reeves, D. S., Bywater, M. J., Holt, H. A., Broughall, J. M. Azlocillin and mezlocillin: Laboratory studies of their properties, including comparison with the antibacterial activity of other antibiotics. Arzneim.-Forsch./Drug Res. 29 (II) (1979) 1920–1929.

    Google Scholar 

  20. Sonntag, H.-G., Hingst, V. Vergleichsuntersuchungen zur Antibiotikaresistenz bei Anaerobiern. Therapiewoche 30 (1980) 1526–1530.

    Google Scholar 

  21. Thadepalli, H., Roy, I., Bach, V. T., Webb, D. In vitro activity of mezlocillin and its related compounds against aerobic and anaerobic bacteria. Antimicrob. Agents Chemother. 15 (1979) 487–490.

    Google Scholar 

  22. Schacht, P., Tettenborn, D., Hullmann, R., Bruck, H. Ergebnisse der klinischen Prüfung von Mezlocillin. Arzneim.-Forsch. 29 (II) (1979) 1981–1985.

    Google Scholar 

  23. Lode, H. Antibiotika-Prophylaxe. Zschr. Chemother. 2 (1981) 1–3.

    Google Scholar 

  24. Höjer, H. The effect on total antimicrobial consumption and hospitalization-time after prophylactic treatment with doxycycline in colorectal surgery. Acta Chir. Scand. 144 (1978) 175–179.

    Google Scholar 

  25. Green, J. W., Wenzel, R. P. Postoperative wound infection. Ann. Surg. 185 (1977) 264–268.

    Google Scholar 

  26. Kaplan, E. W., Meier, P. Nonparametric estimation from incomplete observations. J. Am. Statist. Assoc. 53 (1958) 457–481.

    Google Scholar 

  27. Mantel, N., Haenszel, W. Statistical aspects of the analysis of data from retrospective studies of disease. J. Natl. Canc. Inst. 22 (1959) 719–748.

    Google Scholar 

  28. Gundert-Remy, J., Förster, D., Schacht, P. Pharmakokinetische Untersuchungen von Mezlocillin unter besonderer Berücksichtigung der Galleausscheidung. Berichte über das Internationale Symposium Acylureido-Penicilline, Stuttgart. Verlag für Angewandte Wissenschaften, München 1978, pp. 137–143.

    Google Scholar 

  29. Werner, H., Krasemann, C., Ungerechts, J., Schmitz, H. J. DieIn-vitro-Aktivität von Mezlocillin, Azlocillin und Carbenicillin gegenBacteroidaceae unter besonderer Berücksichtigung derfragilis-Gruppe. Infection 5 (1977) 17–21.

    Google Scholar 

  30. Wise, R. Azlocillin and mezlocillin, two new amino substituted penicillins. Arzneim.-Forsch./Drug Res. 29 (II) (1979) 1229–1232.

    Google Scholar 

  31. Kjellgren, K., Sellström, H. Effect of prophylactic systemic administration of cephalothin in colorectal surgery. Acta Chir. Scand. 143 (1977) 473–477.

    Google Scholar 

  32. Higgins, A. F., Lewis, A., Noone, P., Hole, M. L. Single and multiple dose cotrimoxazole and metronidazole in colorectal surgery. Br. J. Surg. 67 (1980) 90–92.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Chirurgische Abteilung des Krankenhauses Zehlendorf, Bereich Behring, D-1000, Berlin

    M. Wenzel,  M. Walden &  M. Heinrich

  2. Landes-Medizinal-Untersuchungsamt, Rubensstraße 111, D-1000, Berlin 41

    Barbara Neuhaus

Authors
  1. M. Wenzel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Walden
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Heinrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Barbara Neuhaus
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wenzel, M., Walden, M., Heinrich, M. et al. Die systemische Mezlocillin-Prophylaxe in der elektiven Kolonchirurgie. Infection 10 (Suppl 3), S148–S157 (1982). https://doi.org/10.1007/BF01640660

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01640660

Search

Navigation