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Single-dose cefmetazole versus multiple dose cefoxitin for prophylaxis in abdominal surgery
J T DiPiro1, L S Welage, B A Levine
1University of Georgia College of Pharmacy, Augusta.
The Journal of Antimicrobial Chemotherapy
|April 1, 1989
Summary
Single-dose cefmetazole is as effective as a three-dose cefoxitin regimen for preventing surgical site infections after abdominal surgery. This finding supports cefmetazole
Area of Science:
- Surgical Infection Prophylaxis
- Antibiotic Efficacy
- Pharmacology
Background:
- Postoperative wound infections are a significant complication following abdominal surgical procedures.
- Current prophylactic antibiotic regimens often involve multiple doses, increasing complexity and potential for non-adherence.
- Cefmetazole and cefoxitin are cephalosporin antibiotics commonly used for surgical prophylaxis.
Purpose of the Study:
- To compare the safety and efficacy of single-dose cefmetazole versus a multi-dose cefoxitin regimen for preventing surgical site infections (SSIs) in patients undergoing abdominal surgery.
- To evaluate the non-inferiority of cefmetazole in SSI prevention compared to cefoxitin.
Main Methods:
- A multicenter, randomized, open-label study involving 195 patients undergoing abdominal surgery.
- Patients received either a single intravenous dose of cefmetazole (2g) or a standard regimen of cefoxitin (2g preoperatively, followed by 2g doses every 6 hours).
- Dosing adjustments were made for longer surgical durations; colorectal surgery patients also received oral neomycin and erythromycin bowel preparation.
Main Results:
- The overall operative site infection rate was comparable between the two groups: 6.5% for cefmetazole and 7.7% for cefoxitin (P > 0.05).
- No serious drug-related adverse effects were reported for either antibiotic.
- Colorectal operations were the most frequent procedure (49%), followed by cholecystectomies (26%) and gastroduodenal procedures (21%).
Conclusions:
- Single-dose cefmetazole demonstrates equivalent efficacy to a standard three-dose cefoxitin regimen in preventing SSIs after abdominal operations.
- The findings suggest that a simplified, single-dose cefmetazole regimen is a viable and effective option for surgical prophylaxis in this patient population.
- This simplified regimen may improve adherence and reduce healthcare resource utilization associated with multi-dose protocols.