Nachtkamp J, Peiper C, Schumpelick V
Chirurgische Klinik, RWTH Aachen.
Klin Wochenschr. 1991;69 Suppl 26:61-6.
In a prospective, randomized trial in 200 patients who underwent abdominal surgery, we compared the prophylactic effect of a single dose of 1.5 g Cefuroxime against three doses of 2 g Cefoxitin. The incidence of wound infections was 8.2% in both groups. No difference was found between the two groups in the incidence of other infections except for urinary tract infections, whose frequency was twice as high in the Cefuroxime-treated group. In all patients we swabbed material from the anastomosis for microbiological investigation. However, these results did not enable the prediction of a wound infection or the determination as to which specimen caused the infection. In our pharmacokinetic investigations we obtained better results in the Cefuroxime-treated group due to the drug's longer half-life. On the other hand, we found extreme interindividual variation in the results obtained in both groups. This not well known factor probably raises the incidence of wound infection.
在一项针对200例行腹部手术患者的前瞻性随机试验中,我们比较了单剂量1.5克头孢呋辛与三剂量2克头孢西丁的预防效果。两组伤口感染发生率均为8.2%。除尿路感染外,两组在其他感染发生率方面未发现差异,头孢呋辛治疗组的尿路感染发生率是对照组的两倍。我们对所有患者的吻合口拭子样本进行了微生物学调查。然而,这些结果无法预测伤口感染情况,也无法确定是哪个样本导致了感染。在我们的药代动力学研究中,由于头孢呋辛的半衰期较长,头孢呋辛治疗组获得了更好的结果。另一方面,我们发现两组结果存在极大的个体差异。这个尚不为人熟知的因素可能会提高伤口感染的发生率。