Double-blind comparison of cefazolin and cephalothin in open-heart surgery

Ninety-nine patients undergoing cardiac surgery were randomly assigned to treatment with cefazolin and cephalothin to compare the effectiveness of these cephalosporins in the prevention of postoperative infections. The incidence of infections was low with both antibiotics (cefazolin 2.1 percent, cephalothin 4.6 percent). Intraoperative serum cefazolin levels were more evenly distributed, whereas a wide dispersion of cephalothin levels was observed. There was no measurable antibiotic detected in cardiac tissue samples in the majority of the cases. Adverse reactions (skin rashes) occurred only in three patients, all receiving cephalothin. It is concluded that cefazolin is as safe and effective as cephalothin in the prevention of postoperative infection in patients undergoing open-heart surgery.