Single-dose prophylaxis with cefotetan in elective abdominal surgery. A controlled trial

Area of Science:

• Surgical prophylaxis
• Infectious disease
• Pharmacology

Background:

• Surgical site infections (SSIs) are a significant concern in abdominal surgery.
• Optimizing antibiotic prophylaxis is crucial for reducing postoperative complications.
• Cefotetan is a cephalosporin antibiotic with activity against common pathogens involved in abdominal surgery.

Purpose of the Study:

• To evaluate the efficacy of single-dose cefotetan for surgical prophylaxis in elective abdominal surgery.
• To compare single-dose cefotetan with combination therapy (metronidazole and cefazolin) and multi-dose cefuroxime.
• To assess the benefit of a two-dose regimen of cefotetan compared to a single dose.

Main Methods:

• Prospective comparative study involving elective abdominal surgery patients.
• Antibiotic prophylaxis regimens included single-dose cefotetan, cefotetan plus metronidazole/cefazolin for 24 hours, and three doses of cefuroxime.
• A subset compared single-dose cefotetan with a two-dose regimen (12 hours apart).
• Infection rates (wound, UTI, RTI) were monitored postoperatively.

Main Results:

• No significant differences in wound infections or remote site infections (urinary tract infection [UTI], respiratory tract infection [RTI]) were observed among the groups.
• A single 2g dose of cefotetan demonstrated comparable efficacy to a two-dose regimen.
• The overall low incidence of postoperative infections suggests effective prophylaxis across all evaluated regimens.

Conclusions:

• Single-dose cefotetan is an effective prophylactic agent for elective abdominal surgery.
• Cefotetan demonstrates comparable efficacy to standard combination therapy and multi-dose cefuroxime.
• A single dose of cefotetan appears sufficient, with no added benefit from a second dose given 12 hours later.