Cefamandole versus cefoxitin prophylaxis in patients undergoing cholecystectomy.

A prospective, randomized, double-blind study of three different antibiotic prophylaxis regimens in 150 patients undergoing cholecystectomy was conducted. Group I patients received a 1-gram preoperative dose of cefamandole followed by 4 additional postoperative doses at 6-hour intervals. Group II received a similar regimen except that 2-gram doses of cefamandole were used. Group III received a comparable cefoxitin regimen in 2-gram doses. The patients were deemed to be at high risk for postoperative infection by virtue of the fact that most (almost 70%) were obese and all had had a recent attack of cholecystitis. There were no significant differences among the 3 groups with respect to postoperative infectious complications. It is concluded that perioperative cefamandole and cefoxitin are both effective in reducing the postoperative infectious complications of cholecystectomy. A 5-gram course of cefamandole is as effective as either a 10-gram course of cefamandole or a 10-gram course of cefoxitin and could provide a substantial savings in cost.