Double-blind comparison of phlebitis associated with cefazolin and cephalothin

In a double-blind, crossover study in 28 patients having infections susceptible to cephalosporins (mostly Staphylococcus or Streptococcus), phlebitis developed in twice as many patients (46.4%) receiving intravenous cephalothin within 48 hours, as in patients (21.4%) receiving intravenous cefazolin over the same time period. Likewise, drug therapy had to be discontinued more frequently with cephalothin (39%) than with cefazolin (21%), and the percentage of patients reporting pain or discomfort scores of 1+ or higher was greater with cephalothin (46.4%) than with cefazolin (21.4%). In our study, the intravenous administration of cefazolin was associated with a lower incidence of phlebitis than was cephalothin.