Rayburn W, Varner M, Galask R, Petzold C R, Piehl E
Antimicrob Agents Chemother. 1985 Mar;27(3):337-9. doi: 10.1128/AAC.27.3.337.
Prophylactic antibiotics have been shown to be effective in decreasing the incidence of febrile morbidity associated with cesarean section after labor. However, the relative effectiveness of different single antibiotics has been studied infrequently, and these investigations have been limited by small patient samples. Several new, broad-spectrum antibiotics are now available, and any further benefit from more traditional antibiotics for surgical prophylaxis remains untested. A randomized prospective double-blind therapeutic trial was therefore undertaken to compare the value of a first-generation cephalosporin (cefazolin) with a new third-generation cephalosporin (moxalactam). Between July 1981 and June 1983, 254 qualifying women who underwent primary cesarean section after labor were randomly chosen for either of the two treatment groups. Although not statistically significant, the rates of febrile morbidity, wound infection, and endometritis were less for those treated with cefazolin (4.0, 3.2, and 0.8%, respectively) than for those treated with moxalactam (9.2, 7.7, and 1.6%, respectively). No serious adverse effects were apparent in the mother and newborn infant from short-term exposure to either drug. Although the newer, more expensive, and broader-spectrum cephalosporin, moxalactam, was associated with a low postoperative febrile morbidity rate and short postpartum hospitalization, it was no more beneficial than cefazolin.
预防性抗生素已被证明可有效降低产后剖宫产相关的发热性发病率。然而，不同单一抗生素的相对有效性鲜有研究，且这些调查因患者样本量小而受到限制。现在有几种新型广谱抗生素可供使用，而传统抗生素用于手术预防是否还有更多益处仍未得到检验。因此，我们进行了一项随机前瞻性双盲治疗试验，以比较第一代头孢菌素（头孢唑林）和新型第三代头孢菌素（拉氧头孢）的价值。在1981年7月至1983年6月期间，254名产后接受初次剖宫产的合格女性被随机分为两个治疗组。虽然差异无统计学意义，但接受头孢唑林治疗的患者发热性发病率、伤口感染和子宫内膜炎的发生率分别为4.0%、3.2%和0.8%，低于接受拉氧头孢治疗的患者（分别为9.2%、7.7%和1.6%）。母亲和新生儿短期接触这两种药物均未出现明显严重不良反应。虽然更新、更昂贵且更广谱的头孢菌素拉氧头孢术后发热性发病率低且产后住院时间短，但它并不比头孢唑林更具优势。
