Thomas W E, Cooper M J, Holt A, Reeves D
J Antimicrob Chemother. 1985 Jul;16(1):121-8. doi: 10.1093/jac/16.1.121.
To assess the suitability of latamoxef (moxalactam) as single agent chemoprophylaxis in elective colorectal surgery, 120 consecutive patients were randomized to receive latamoxef (L) 1 g or cephazolin 1 g and metronidazole 500 mg (CM) administered intravenously at induction of anaesthesia and 6 and 12 h postoperatively. The groups were well matched for age, sex, pathology and procedures. Serum and tissue levels of latamoxef were well above the MIC90 for most bowel organisms. Inpatient stay was similar for both groups. Pyrexia was seen in 44 patients (11 L, 23 CM) and eight developed a wound infection (3 L, 5 CM). Major intra-abdominal sepsis occurred in seven patients (2 L, 5 CM), secondary to anastomotic leakage in four (1 L, 3 CM). Twenty patients developed a chest infection (5 L, 15 CM) and eight urinary sepsis (2 L, 6 CM). No bleeding complication occurred, and there was no difference in clotting function between the two groups. Six patients died prior to follow-up at six weeks (1 L, 5 CM), two from anastomotic dehiscence. All but three wounds had healed (1 L, 2 CM) and one further patient had an incisional hernia (CM). These results suggest that latamoxef is an efficient chemoprophylactic agent in elective colorectal surgery, and is marginally better than cephazolin plus metronidazole.
为评估拉氧头孢（羟羧氧酰胺菌素）作为择期结直肠手术单药化学预防用药的适用性，120例连续患者被随机分为两组，一组接受1g拉氧头孢（L组），另一组接受1g头孢唑林加500mg甲硝唑（CM组），于麻醉诱导时及术后6小时和12小时静脉给药。两组在年龄、性别、病理类型和手术方式方面匹配良好。拉氧头孢的血清和组织浓度对大多数肠道细菌而言远高于其MIC90。两组患者的住院时间相似。44例患者出现发热（L组11例，CM组23例），8例发生伤口感染（L组3例，CM组5例）。7例患者发生严重腹腔内感染（L组2例，CM组5例），其中4例（L组1例，CM组3例）继发于吻合口漏。20例患者发生肺部感染（L组5例，CM组15例），8例发生泌尿道感染（L组2例，CM组6例）。未发生出血并发症，两组凝血功能无差异。6例患者在六周随访前死亡（L组1例，CM组5例），2例死于吻合口裂开。除3例伤口外（L组1例，CM组2例），其余伤口均已愈合，另有1例患者发生切口疝（CM组）。这些结果表明，拉氧头孢在择期结直肠手术中是一种有效的化学预防药物，略优于头孢唑林加甲硝唑。
