Gentry L O
Infectious Diseases Section, Saint Luke's Episcopal Hospital, Houston, Texas.
Am J Med. 1990 Apr 9;88(4A):32S-37S. doi: 10.1016/0002-9343(90)90325-8.
Cefotaxime, a third-generation cephalosporin, is active against many troublesome gram-negative organisms and anaerobes that now more frequently cause nosocomial infection. Single-dose cefotaxime, 1 g or 2 g administered 30 minutes prior to surgery, has been proven to be effective as prophylaxis for infection following gastrointestinal, biliary, obstetric, gynecologic, and genito-urinary procedures. When published trials are compiled, single-dose cefotaxime is more effective than multiple-dose cefazolin (p less than 0.01) in these types of surgery. Unfortunately, the dramatic increase in cephalosporin use has been accompanied by the emergence of resistant organisms such as enterococci and fungi. In Europe, some centers successfully prevent nosocomial pneumonia in intubated patients by decontaminating gastric contents with a combination of nonabsorbable antimicrobial agents including cefotaxime. Further trials may validate this concept for use in the United States.
头孢噻肟是第三代头孢菌素，对许多现在更频繁引起医院感染的麻烦革兰氏阴性菌和厌氧菌有活性。在手术前30分钟给予1克或2克单剂量头孢噻肟，已被证明作为胃肠道、胆道、产科、妇科和泌尿生殖系统手术后感染的预防是有效的。当汇总已发表的试验时，在这些类型的手术中，单剂量头孢噻肟比多剂量头孢唑林更有效（p小于0.01）。不幸的是，头孢菌素使用的急剧增加伴随着耐药菌如肠球菌和真菌的出现。在欧洲，一些中心通过用包括头孢噻肟在内的不可吸收抗菌剂组合对胃内容物进行去污，成功预防了插管患者的医院获得性肺炎。进一步的试验可能会验证这一概念在美国的应用。
