Hemsell D L, Menon M O, Friedman A J
Am J Surg. 1984 Oct 19;148(4A):22-6.
A prospective, double-blind, perioperative prophylactic antibiotic study was performed in 127 women undergoing vaginal hysterectomy. Patients were randomly given a preoperative 1 g dose of ceftriaxone and then placebo 8 and 16 hours later or three 1 g doses of cefazolin over 16 hours. At surgery, blood samples were collected from 81 women and vaginal mucosa samples, from 49 women. Respective antibiotic concentrations were determined by high-pressure liquid chromatography. During the 10 months of this study, 64 patients received ceftriaxone and 63 received cefazolin. Clinical and surgical profiles of the two groups were similar, and the incidence of postoperative pelvic infection was identical, being 1.6 percent. The mean concentration of ceftriaxone was significantly higher than that of cefazolin in serum (p less than 0.001) and vaginal mucosa (p less than 0.05). A single dose of ceftriaxone before surgery was as effective in preventing major pelvic infection and urinary tract infection as were three perioperative doses of cefazolin given over 16 hours. The safety and tolerance of the two regimens were equivalent.
对127例行阴道子宫切除术的女性进行了一项前瞻性、双盲、围手术期预防性抗生素研究。患者被随机给予术前1克剂量的头孢曲松，然后在8小时和16小时后给予安慰剂，或在16小时内分三次给予1克剂量的头孢唑林。手术时，从81名女性身上采集血样，从49名女性身上采集阴道黏膜样本。通过高压液相色谱法测定各自的抗生素浓度。在本研究的10个月期间，64例患者接受了头孢曲松，63例接受了头孢唑林。两组的临床和手术情况相似，术后盆腔感染的发生率相同，均为1.6%。头孢曲松在血清（p<0.001）和阴道黏膜（p<0.05）中的平均浓度显著高于头孢唑林。术前单次剂量的头孢曲松在预防主要盆腔感染和尿路感染方面与16小时内围手术期三次剂量的头孢唑林效果相同。两种治疗方案的安全性和耐受性相当。
