CEFTRIAXONE (SINGLE-DOSE) VERSUS CEFOXITIN (MULTIPLE DOSES) - SUCCESSAND FAILURE OF ANTIBIOTIC-PROPHYLAXIS IN 1052 CESAREAN-SECTIONS

The efficacy of perioperative antibiotic prophylaxis in cesarean secti on with a single dose of ceftriaxone, a long-acting cephalosporin not widely used for prophylaxis, was tested. Ceftriaxone as a single dose of 1 g i. v. versus three doses of cefoxitin 1 g i. v. respectively we re used in a prospective, randomized, controlled study consisting of 1 052 patients undergoing cesarean section. Postoperative infection rate as measured by fever, endometritis and wound infection was 6.5% with ceftriaxone and 6.4% with cefoxitin. Urinary tract infections were sig nificantly more frequent in the cefoxitin than in the ceftriaxone grou p (17.8% vs. 9.7%, p < 0.001). Enterococci and Escherichia coli accoun ted for urinary tract infections 1.86-, respectively, 4.3-fold more fr equently with cefoxitin than with ceftriaxone. The time Of hospitaliza tion in patients with urinary tract infections was significantly lower with ceftriaxone than with cefoxitin (11 vs. 12 days, p < 0.05). The tolerance in both groups was equally satisfactory. A single dose of ce ftriaxone, which is simple, reliable (compliance), well tolerated, ine xpensive (fewer urinary tract infections and therefore fewer treatment costs than with cefoxitin) and safe (no overgrowth of pathogens) in o ur opinion is the antibiotic regimen of choice for prophylaxis in cesa rean section in the described circumstances.