Rotman N
Service de Chirurgie Générale, Hôpital Henri-Mondor, Créteil.
Chirurgie. 1990;116(4-5):401-3.
In order to compare the efficacy of antibiotic therapy using Cefalozin or Cefotaxime, 3,137 patients operated with an abdominal approach were included into a multidepartmental prospective study by lot. The patients were distributed into 4 levels according to the degree of intraoperative contamination and to the risk factors they presented. The patients in each level were distributed by lot into three treatment groups: 1) Cefalozin, 2) Cefotaxime, 3) no treatment. The antibiotics were delivered perioperatively in 3 doses of 1 g every eight hours. The patients having had colic surgery or operated for peritonitis were excluded from the study. The number of intestinal wall abscesses was significantly lower in the treated groups, except in level 3 (contaminated surgery). The percentage of postoperative peritonitis was twice lower in the treated groups than in the control group. There was no difference between the treated groups. The patients included in the treated groups were given significantly less antibiotics than the patients of the control group. As far as costs are concerned, antibiotic prophylaxis with Cefalozin is effective in all procedures of abdominal surgery in which the degree of contamination by anaerobes is low.
为比较头孢唑林或头孢噻肟抗生素治疗的疗效，3137例接受腹部手术的患者通过抽签纳入一项多科室前瞻性研究。根据术中污染程度和所呈现的危险因素，将患者分为4个级别。每个级别的患者通过抽签分为三个治疗组：1）头孢唑林组，2）头孢噻肟组，3）不治疗组。抗生素在围手术期以每8小时1g的剂量分3次给药。接受绞痛手术或因腹膜炎接受手术的患者被排除在研究之外。除3级（污染手术）外，治疗组肠壁脓肿的数量明显较少。治疗组术后腹膜炎的发生率比对照组低两倍。治疗组之间没有差异。治疗组患者使用的抗生素明显少于对照组患者。就成本而言，头孢唑林预防性使用抗生素在厌氧菌污染程度较低的所有腹部手术中均有效。
