Prospective randomized trial of single dose cefuroxime against mezlocillin in elective gastric surgery

A prospective randomized control trial was made in 78 patients undergoing elective operations on the stomach where the viscus was opened at operation, and the efficacy of single dose intravenous prophylaxis with cefuroxime 1.5 g or mezlocillin 2 g was compared. The overall rate of sepsis was 10.2 per cent. Infection in the cefuroxime group was significantly lower (2.5 per cent) than in the mezlocillin group (18 per cent) (P less than 0.05). Four of the seven patients with infections in the mezlocillin group were due to antibiotic resistant staphylococci. The only infections in the cefuroxime group were due to an antibiotic resistant strain of Pseudomonas aeruginosa. One case of pseudomembranous colitis occurred in the cefuroxime group. In view of the high rate of resistant organisms in patients receiving mezlocillin we believe that cefuroxime remains the antibiotic of choice for patients undergoing elective gastric operations.