Cefotetan: comparative and noncomparative studies in obstetric and gynecologic infections

Cefotetan is a recently introduced cephamycin antibiotic for parenteral administration, with a broad spectrum of antibacterial activity. Its elimination half-life of three hours or more allows a twice-daily dosage schedule. A noncomparative trial of cefotetan yielded a satisfactory clinical response in the treatment of all of ten patients with pelvic infection. Subsequently, we did a prospective, randomized comparative study of 53 patients with pelvic infections treated with either cefotetan (2 gm IV every 12 hours) or cefoxitin (2 gm IV every six to eight hours). Both drugs showed similar clinical efficacy and antimicrobial activity (100% [n = 36] with cefotetan and 94% [n = 17] with cefoxitin, the difference not statistically significant). A mean of 21.3 gm of cefotetan was required, as compared with 34.4 gm of cefoxitin, a statistically significant difference (P less than .001). Use of cefotetan is therefore more cost effective.