Leaper D J, Cooper M J, Turner A
J Hosp Infect. 1986 May;7(3):269-76. doi: 10.1016/0195-6701(86)90077-0.
Cefotetan is a cephamycin antibiotic theoretically suited to prophylaxis of wound infection during upper elective gastrointestinal surgery. In a prophylaxis trial 100 patients undergoing this type of surgery were randomly allocated to receive 1g cefotetan or cephazolin iv at induction of anaesthesia. Cefotetan-treated patients had significantly fewer postoperative infections overall (P less than 0.05) and there were no wound infections recorded in this group. In a separate pharmacokinetic study the penetration of cefotetan into common bile duct bile and gallbladder wall was measured in a further six patients, all of whom had been jaundiced preoperatively. At the time of maximum risk concentrations of cefotetan in bile and biliary tissue as well as blood and wound fat were in excess of the minimum inhibitory concentration for the majority of relevant pathogens. Cefotetan appears to be equally or more effective than cephazolin and is a suitable alternative prophylactic agent in elective upper gastrointestinal surgery.
头孢替坦是一种头霉素类抗生素，理论上适用于择期上消化道手术期间伤口感染的预防。在一项预防试验中，100例接受此类手术的患者在麻醉诱导时被随机分配接受1g静脉注射头孢替坦或头孢唑林。总体而言，接受头孢替坦治疗的患者术后感染明显较少（P<0.05），且该组未记录到伤口感染。在另一项药代动力学研究中，对另外6例术前均有黄疸的患者测定了头孢替坦在胆总管胆汁和胆囊壁中的渗透情况。在胆汁、胆道组织以及血液和伤口脂肪中头孢替坦达到最大风险浓度时，其浓度超过了大多数相关病原体的最低抑菌浓度。头孢替坦似乎与头孢唑林同样有效或更有效，是择期上消化道手术中合适的预防性替代药物。
