Ghoneim A T, Tandon A P, Ionescu M I
Ann Thorac Surg. 1982 Feb;33(2):152-8. doi: 10.1016/s0003-4975(10)61902-9.
A randomized, prospective study of the efficacy of cefamandole naftate versus a combination of ampicillin and cloxacillin was undertaken in 109 adult patients operated on in Leeds during 1979. Sixty patients underwent valve replacement, and 49 had either aortocoronary bypass grafts or other forms of open-heart operation. Teh two groups matched well in age, sex, and type of operation. One gram of either antibiotic was given intravenously during the induction of anesthesia and every 6 hours thereafter for 48 hours. Two additional grams of antibiotic were placed in the prime of the heart lung machine. The overall rate of infection was 7.5% for the entire series, with 1.7% for the group given cefamandole and 13.7% for the group given ampicillin plus cloxacillin (p less than 0.05). The only patient with infection in the former group (1.7%) had sternal wound involvement. Major sternal wound infection occurred in 3 (5.9%) patients in the latter group. All wound infections were caused by Staphylococcus aureus. In 2 of these patients (ampicillin plus cloxacillin group) the infection proceeded to endocarditis. Urinary and respiratory tract infections occurred in 1.9% and 5.9%, respectively, of patients given ampicillin plus cloxacillin. The duration of hospital stay was shorter in the cefamandole group. The results of this study demonstrated that cefamandole confers effective prophylaxis in cardiac operations.
1979年，在利兹对109例接受手术的成年患者进行了一项关于萘夫西林头孢孟多与氨苄西林和氯唑西林联合用药疗效的随机前瞻性研究。60例患者接受了瓣膜置换术，49例进行了主动脉冠状动脉搭桥术或其他形式的心脏直视手术。两组在年龄、性别和手术类型方面匹配良好。在麻醉诱导期间静脉注射1克抗生素，此后每6小时注射一次，共48小时。另外2克抗生素加入心肺机的预充液中。整个系列的总体感染率为7.5%，接受头孢孟多的组为1.7%，接受氨苄西林加氯唑西林的组为13.7%（p<0.05）。前一组中唯一感染的患者（1.7%）有胸骨伤口感染。后一组中有3例（5.9%）患者发生了严重的胸骨伤口感染。所有伤口感染均由金黄色葡萄球菌引起。在其中2例患者（氨苄西林加氯唑西林组）中，感染发展为心内膜炎。接受氨苄西林加氯唑西林的患者中，尿路感染和呼吸道感染的发生率分别为1.9%和5.9%。头孢孟多组的住院时间较短。这项研究的结果表明，头孢孟多在心脏手术中具有有效的预防作用。
