1988 Volume 36 Issue 7 Pages 493-499
The safety and efficacy of ceftizoxime (CZX), a third-generation cephalosporin, were compared to those of cefoxitin (CFX), a second-generation cephalosporin, for prophylaxis in patients undergoing elective gastric surgery.
Two hundred and two patients were randomised for therapy with CZX 2g i. v. in the operating room before the surgical procedure and 1g 8-hourly for 4 days or CFX 2g i. v. before the surgical procedure and 1g 8-hourly for 4 days. One hundred and two cases were given CZX and 100 cases were given CFX. The groups were comparable in age, sex, type of intervention and diagnosis.
Nine patients (6.9%) developed postoperative infections (including wound sepsis 1, intraabdominal abscess 2, and 6 others) in the CZX group. Twenty-seven patients (27.0%) developed postoperative infections (including wound sepsis 2, intraabdominal abscess 15, anastomotic leakage 2, and 8 others) in the CFX group. The rate of postoperative infection was significantly different between the groups (p<0.01). There were 3 patients with diarrhea and 1 with eosinophilia in the CZX group. In the CFX group, there were 5 patients with diarrhea and 1 with mild skin eruption. In both groups, no patient was found to have C. difficile cytotoxin in the stool. Diarrhea was mild in all patients and they recovered rapidly without further problems. In the early postoperative period, abnormal liver function was noted in 33 patients (16 cases in the CZX and 17 in the CFX group). The rates of sideeffects and abnormal laboratory features were not significantly different between the groups.
This study suggests that, compared to CFX, CZX is a better prophylactic agent in patients undergoing elective gastric surgery.
