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A comparison between amoxycillin/clavulanate and mezlocillin in abdominal surgical prophylaxis
D Menzies1, J M Gilbert, M J Shepherd
1Department of Surgery, Westminster Hospital, London, UK.
Abstract:
A randomized comparative study was conducted to evaluate the clinical efficacy of amoxycillin/clavulanate (Augmentin) compared with mezlocillin for the prevention of wound infection in patients undergoing abdominal surgery. There was no difference in overall wound infection rates between the amoxycillin/clavulanate treated group and the mezlocillin group. When sub-groups were examined for total infections no significant difference was seen between antibiotic groups in patients undergoing clean/potentially contaminated operations or contaminated operations, although more deep infections were encountered in the amoxycillin/clavulanate group in comparison with the mezlocillin group, in contaminated operations. The type of operation performed also failed to show any difference in those patients undergoing upper gastro-intestinal, appendiceal, colonic, or biliary operations. The infections in those receiving amoxycillin/clavulanate were largely of bowel origin and predominantly sensitive to amoxycillin/clavulanate. Those in the mezlocillin group were predominantly staphylococcal in origin. Amoxycillin/clavulanate appears to be an effective antibiotic for use as a single agent in surgical prophylaxis.
Insights
Amoxycillin/clavulanate demonstrated effectiveness comparable to mezlocillin in preventing surgical wound infections. Both antibiotics showed similar overall efficacy, with amoxycillin/clavulanate proving suitable as a single-agent prophylaxis.
Area of Science:
- Surgical Infectious Diseases
- Pharmacology
- Clinical Microbiology
Background:
- Surgical site infections (SSIs) are a significant complication following abdominal surgery.
- Antibiotic prophylaxis is crucial in reducing the incidence of SSIs.
- Evaluating the comparative efficacy of different antibiotic regimens is essential for optimizing surgical care.
Purpose of the Study:
- To compare the clinical efficacy of amoxycillin/clavulanate versus mezlocillin for preventing wound infections in patients undergoing abdominal surgery.
- To assess the impact of operation type on infection rates and microbial origins.
- To determine the suitability of amoxycillin/clavulanate as a single-agent prophylactic antibiotic.
Main Methods:
- A randomized comparative study design.
- Patient enrollment in abdominal surgery cohorts.
- Administration of amoxycillin/clavulanate or mezlocillin for prophylaxis.
- Analysis of overall and sub-group wound infection rates, including deep infections.
- Microbiological characterization of isolated pathogens and their antibiotic sensitivities.
Main Results:
- No significant difference in overall wound infection rates between amoxycillin/clavulanate and mezlocillin groups.
- Similar infection rates across clean/potentially contaminated and contaminated operations.
- A trend towards more deep infections in the amoxycillin/clavulanate group during contaminated operations.
- Infections in the amoxycillin/clavulanate group were primarily of bowel origin and sensitive to the antibiotic.
- Infections in the mezlocillin group were predominantly staphylococcal.
Conclusions:
- Amoxycillin/clavulanate is an effective antibiotic for surgical prophylaxis in abdominal surgery.
- It demonstrates comparable efficacy to mezlocillin in preventing wound infections.
- Its use as a single agent for prophylaxis is supported by the study findings.