A comparison of the prophylactic efficacy of ceftriaxone and cefotaxime in abdominal surgery.

Abstract

BACKGROUND:

Although ceftriaxone (R) and cefotaxime (C) are highly effective antibiotics, few studies have directly compared their prophylactic efficacy.

METHODS:

In a prospective, randomized, double blind study of 1,013 patients undergoing abdominal surgery, the prophylactic use of ceftriaxone and cefotaxime were compared. Intravenous cephalosporin, 1 g, was given at induction of anesthesia, with intravenous metronidazole, 500 mg, also being given for colorectal surgery.

RESULTS:

The difference in wound infection (R 8%, C 12%, P <0.05) was due to appendicectomies not receiving metronidazole, (R 6%, C 18%, P <0.03) and was no longer present when these cases were excluded from analysis (R 8%, C 10%). Of note chest and urinary tract infection (R 6%, C 11%, P <0.02) and "any" infection (R 20%, C 27%, P <0.05) were reduced with ceftriaxone.

CONCLUSIONS:

Both antibiotics provide comparable wound prophylaxis as long as metronidazole is added for colorectal and appendiceal surgery. Ceftriaxone may be more versatile having the additional apparent benefits of reducing other postoperative infections, being less dependent on metronidazole as an adjunct and providing a more effective prophylactic cover against Staphylococcus aureus.

• Authors: John C Woodfield, Andre M Van Rij, Ross A Pettigrew, Antje J van der Linden, Clive Solomon, Donna Bolt
• Journal: American journal of surgery (Am J Surg) Vol. 185 Issue 1 Pg. 45-9 (Jan 2003) ISSN: 0002-9610 [Print] United States
• PMID: 12531444 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Ceftriaxone
• Cefotaxime

Topics

• Abdomen (surgery)
• Adult
• Aged
• Antibiotic Prophylaxis
• Cefotaxime (administration & dosage)
• Ceftriaxone (administration & dosage)
• Digestive System Diseases (diagnosis, surgery)
• Dose-Response Relationship, Drug
• Double-Blind Method
• Female
• Follow-Up Studies
• Humans
• Infusions, Intravenous
• Male
• Middle Aged
• Probability
• Prospective Studies
• Reference Values
• Surgical Wound Infection (prevention & control)
• Treatment Outcome