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Prophylaxis in caesarean section with cefmetazole and cefoxitin
W R Crombleholme1, J R Green, M Ohm-Smith
1Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco.
The Journal of Antimicrobial Chemotherapy
|April 1, 1989
Summary
Cefmetazole and cefoxitin demonstrated equivalent efficacy in preventing endomyometritis following Cesarean sections. Both antibiotics showed similar rates of infection and fever, indicating comparable safety and effectiveness in this surgical context.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Pharmacology
Background:
- Postoperative infectious morbidity, particularly endomyometritis, remains a concern following Cesarean sections.
- Antibiotic prophylaxis is crucial in preventing such infections.
- Cefmetazole and cefoxitin are commonly used cephalosporins for surgical prophylaxis.
Purpose of the Study:
- To compare the efficacy of cefmetazole versus cefoxitin in preventing endomyometritis after non-elective Cesarean sections.
- To evaluate and compare febrile morbidity between the two antibiotic treatment groups.
Main Methods:
- A prospective, randomized, open-label study comparing cefmetazole (1g doses) with cefoxitin (2g doses) in 69 patients undergoing non-elective Cesarean section.
- Patients were assessed for postoperative infectious morbidity, specifically endomyometritis.
- Fever index was used to quantify febrile morbidity.
Main Results:
- The incidence of endomyometritis was similar in both groups: 10% (5/50) for cefmetazole and 10.5% (2/19) for cefoxitin.
- There was no significant difference in febrile morbidity between the cefmetazole (10.2 ± 18.5 degree hours) and cefoxitin (7.5 ± 11.7 degree hours) groups.
- Labor characteristics and amniotic fluid contamination were comparable between groups, ensuring reliable comparison.
Conclusions:
- Cefmetazole is an effective alternative to cefoxitin for preventing endomyometritis in patients undergoing non-elective Cesarean sections.
- Both antibiotics exhibit comparable efficacy and safety profiles in this obstetric surgical setting.