Nelson R M, Benitez P R, Newell M A, Wilson R F
Arch Surg. 1986 Feb;121(2):153-6. doi: 10.1001/archsurg.1986.01400020039003.
A prospective randomized study compared the use of moxalactam disodium vs clindamycin phosphate and tobramycin sulfate for treatment of 190 patients with penetrating abdominal trauma. Twenty-seven patients were disqualified because of early death or failure to follow the protocol. The patients in each group were comparable regarding the cause and severity of injury. No significant difference was seen in the incidence of intra-abdominal infection between the moxalactam-treated group (13%) and the clindamycin- and tobramycin-treated group (9%). The intra-abdominal infection rate in patients with colon injuries (21%) was significantly increased when compared with the patients without colon injuries (6%), but the antibiotic regimen did not significantly change the infection rate. No evidence of bleeding problems from moxalactam were noted. Changes in prothrombin and partial thromboplastin times appeared to be related to shock rather than the use of moxalactam. The most severe coagulopathies occurred prior to moxalactam therapy and were seen only in those patients who had shock requiring 10 or more units of blood. Moxalactam is as effective as combination (clindamycin and tobramycin) antimicrobial therapy in patients with penetrating abdominal trauma.
一项前瞻性随机研究比较了用羟羧氧酰胺菌素二钠与磷酸克林霉素和硫酸妥布霉素治疗190例腹部穿透伤患者的效果。27例患者因早期死亡或未遵循方案而被排除。每组患者在损伤原因和严重程度方面具有可比性。羟羧氧酰胺菌素治疗组（13%）和克林霉素与妥布霉素治疗组（9%）的腹腔内感染发生率未见显著差异。与无结肠损伤的患者（6%）相比，结肠损伤患者的腹腔内感染率（21%）显著升高，但抗生素治疗方案并未显著改变感染率。未观察到羟羧氧酰胺菌素有出血问题的证据。凝血酶原时间和部分凝血活酶时间的变化似乎与休克有关，而非与使用羟羧氧酰胺菌素有关。最严重的凝血障碍发生在羟羧氧酰胺菌素治疗之前，且仅见于那些休克需要输注10个或更多单位血液的患者。在腹部穿透伤患者中，羟羧氧酰胺菌素与联合（克林霉素和妥布霉素）抗菌治疗效果相当。
