Antimicrobial vs placebo prophylaxis in noncardiac thoracic surgery

A prospective, double-blind evaluation of the efficacy and safety of prophylactic cephalosporins was done in 57 patients undergoing noncardiac thoracic surgery. Twenty-eight received cephalosporin therapy, and 29 received placebo. Overall, the incidence of postoperative infections was the same; infections developed in five (17.8%) of the 28 patients in the cephalosporin group and in five (17.2%) of the 29 patients in the placebo group. Of the five deaths attributable to infection, three occurred in patients receiving placebo and two in patients receiving cephalosporin therapy. No differences were noted in WBC counts, fever, duration of hospitalization, hypersensitivity reactions, or abnormal liver functions. However, drug fever, phlebitis, and abnormal renal function occurred more often in the patients receiving cephalosporin therapy.