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头孢西丁(三倍剂量)与头孢呋辛(单次注射)在腹部手术围手术期预防性使用抗生素有效性比较的前瞻性随机研究

[Prospective randomized study of the comparison of the effectiveness of cefoxitin (triple dose) and cefuroxime (single shot) in preventive perioperative use of antibiotics in abdominal surgery].

作者信息

Nachtkamp J, Peiper C, Schumpelick V

机构信息

Chirurgische Klinik, RWTH Aachen.

出版信息

Klin Wochenschr. 1991;69 Suppl 26:61-6.

PMID:1813733
Abstract

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.

摘要

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。

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