Abstract
We compared the safety and efficacy of cefmetazole (CMZ), a second-generation cephalosporin, to those of ceftizoxime (CZX), a third-generation cephalosporin, for prophylaxis in patients undergoing elective upper gastro-intestinal surgery. Eighty-seven patients were randomized for therapy with CMZ 2 gm IV started in the operating room before the surgical procedure and 1 gm 8-hourly for 4 days or CZX 2 gm IV before the surgical procedure and 1 gm 8-hourly for 4 days. Fourty-six patients were given CMZ and 41 patients were given CZX. The groups were comparable in age, sex, type of intervention and diagnosis. Eight patients (17.4%) developed surgery-related infection (including 1 case of wound sepsis and 7 of intra-abdominal abscess) in the CMZ group. Eight patients (19.5%) developed postoperative infections (2 cases of wound sepsis and 6 of intraabdominal abscess) in the CZX group. The rate of postoperative infection was not significantly different between the groups. There were no side effects in either group. In the early postoperative period, abnormal liver function was noted in 9 patients (4 in the CMZ group and 5 in the CZX group), The rate of abnormal laboratory findings was not significantly different between the groups.
