Berkeley A S, Hayworth S D, Hirsch J C, Freedman K S, Ledger W J
Surg Gynecol Obstet. 1985 Nov;161(5):457-61.
Moxalactam was compared with cefazolin and a control group to determine the efficacy and value of a third generation cephalosporin in abdominal hysterectomy antibiotic prophylaxis. One hundred patients were prospectively randomized in a double-blind manner between moxalactam and cefazolin. An additional 50 patients who were either allergic to penicillin or refused participation in this study were simultaneously observed to establish a base line level of infection on our service during this time period. Dosage for both antibiotic groups was 1 gram given intravenously or intramuscularly on call to the operating room followed by two 1 gram doses at six and 12 hours after the first dose. Standard febrile morbidity was 36, 30 and 42 per cent for moxalactam, cefazolin and control groups, respectively. Postoperative surgical infection requiring antibiotic treatment occurred in 8, 6 and 4 per cent, respectively; urinary tract infection or symptomatic findings, or both, requiring treatment occurred in 8, 10 and 10 per cent, respectively. No pelvic abscesses occurred in this series. In every statistical evaluation of postoperative morbidity, there were no differences noted among the three groups. Our results suggest no benefit from the use of prophylactic antibiotics in abdominal hysterectomy in terms of standard febrile or infectious morbidity or urinary tract pathologic findings. In addition, there was no difference between the two antibiotic groups.
将羟羧氧酰胺菌素与头孢唑林及一个对照组进行比较，以确定第三代头孢菌素在腹部子宫切除术中预防性使用抗生素的疗效和价值。100例患者以前瞻性双盲方式随机分为羟羧氧酰胺菌素组和头孢唑林组。另外50例对青霉素过敏或拒绝参与本研究的患者在同一时期被同时观察，以确定我们科室在此期间的感染基线水平。两个抗生素组的用药剂量均为1克，在接到手术室通知时静脉或肌肉注射，随后在首剂后的6小时和12小时各给予1克。羟羧氧酰胺菌素组、头孢唑林组和对照组的标准发热发病率分别为36%、30%和42%。需要抗生素治疗的术后手术感染发生率分别为8%、6%和4%；需要治疗的尿路感染或有症状表现（或两者皆有）的发生率分别为8%、10%和10%。本系列中未发生盆腔脓肿。在对术后发病率的每一项统计学评估中，三组之间均未发现差异。我们的结果表明，就标准发热或感染发病率或泌尿系统病理表现而言，腹部子宫切除术预防性使用抗生素并无益处。此外，两个抗生素组之间也没有差异。
