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Comparison of cefotaxime plus metronidazole versus cefoxitin for prevention of wound infection after abdominal surgery

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Abstract

In a randomized prospective stratified trial consisting of 1010 patients undergoing abdominal surgery involving the viscera, the efficacy of cefotaxime plus metronidazole was compared to cefoxitin for preventing wound infection. The efficacy of a single dose of antibiotics versus three doses over 24 hours was also evaluated. This study demonstrated that a single-dose antibiotic regimen was as effective as a multiple-dose regimen in the prophylaxis of wound infections following abdominal surgery. In addition it demonstrated that the cefotaxime plus metronidazole regimen is comparable to that of cefoxitin and is more cost-effective. It is concluded that a single dose of cefotaxime plus metronidazole provides effective prophylaxis against postoperative wound infections following abdominal surgery.

Résumé

Dans cette étude randomisée, et stratifiée, on a comparé l'efficacité du céfotaxime combiné au métronidazole et du céfotaxime seul, ainsi que leur efficacité en une seule prise par rapport à trois prises, dans la prévention des infections pariétales chez 1010 patients ayant une intervention abdominale concernant les viscères. Une seule prise est aussi efficace que trois. Il n'y avait pas de différence d'efficacité en ce qui concerne les deux traitements d'antibiotiques. Le céfotaxime combiné au métronidazole a un meilleur rapport coût efficacité. Nous recommandons la combinaison céfotaxime et métronidazole dans la prévention des infections pariétales après chirurgie abdominale.

Resumen

Con el propósito de comparar la eficacia de un régimen de cefotaxime más metronidazol con cefoxitina en la prevención de las infecciones de herida, se realizó un estudio prospectivo y randomizado que cubrió a 1010 pacientes sometidos a cirugía abdominal. También se valoró la eficacia de una dosis única de los antibióticos versus tres dosis en el curso de 24 horas. El estudio demostró que el régimen de dosis única de antibiótico fue tan efectivo como el régimen de dosis múltiples en la profilaxis de la infección de herida en cirugía abdominal y, además, señaló que la combinación de cefotaxime y metronidazol es comparable a la de la cefoxitina y es de mayor costo/eficacia.

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Authors and Affiliations

  1. Gastrointestinal Surgical and Liver Transplant Unit, Department of Surgery, Flinders Medical Center, Bedford Park, 5042, Adelaide, South Australia, Australia

    Lilian Kow B.M.B.S. & James Toouli M.B.B.S., Ph.D.

  2. Department of Microbiology and Infectious Diseases, Flinders Medical Center, Bedford Park, 5042, Adelaide, South Australia, Australia

    Judith Brookman R.N. & Peter James McDonald M.B.B.S.

Authors
  1. Lilian Kow B.M.B.S.
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  2. James Toouli M.B.B.S., Ph.D.
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  3. Judith Brookman R.N.
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  4. Peter James McDonald M.B.B.S.
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Kow, L., Toouli, J., Brookman, J. et al. Comparison of cefotaxime plus metronidazole versus cefoxitin for prevention of wound infection after abdominal surgery. World J. Surg. 19, 680–686 (1995). https://doi.org/10.1007/BF00295902

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