Huizinga W K, Robbs J V, Kritzinger N A
S Afr Med J. 1982 Jul 28;62(5 Spec No):13A-15A.
In a series of 64 patients requiring amputation for lower limb sepsis, the performance of a new antibiotic combination with beta-lactamase-inhibiting properties, amoxycillin plus clavulanic acid (A-CA) (Augmentin; Beecham) in the prophylaxis of postoperative wound sepsis, was compared with that of a combination of amoxycillin and ampicillin (A-A) (Suprapen; Bencard) and a control group. The sepsis rate following A-CA prophylaxis (12,9%) was significantly less than in the control group (x 2 = 18, 49; P less than 0,001). Although not attaining statistical significance (x 2 = 2, 12),, A-CA compared favourably with A-A (sepsis rate 35.3%) in the prevention of post-amputation wound sepsis. There was no statistically significant difference in the development of sepsis between wounds closed primarily and those left unsatured while under A-CA cover. It is concluded that peri-operative antibiotic cover for amputations in septic lower limb lesions is advisable and that A-CA is a valuable antibiotic in this situation.
在一系列64例因下肢脓毒症而需要截肢的患者中，将一种具有β-内酰胺酶抑制特性的新型抗生素组合阿莫西林加克拉维酸（A-CA）（安灭菌；必治妥）在预防术后伤口脓毒症方面的效果，与阿莫西林和氨苄西林组合（A-A）（舒普深；本卡德）以及一个对照组进行了比较。接受A-CA预防后的脓毒症发生率（12.9%）显著低于对照组（χ² = 18.49；P < 0.001）。虽然未达到统计学显著性（χ² = 2.12），但在预防截肢后伤口脓毒症方面，A-CA与A-A（脓毒症发生率35.3%）相比效果良好。在A-CA覆盖下，一期缝合的伤口和未缝合的伤口在脓毒症发生方面没有统计学显著差异。得出的结论是，对于感染性下肢病变的截肢手术，围手术期使用抗生素预防是可取的，并且在这种情况下A-CA是一种有价值的抗生素。
