EFFECTIVENESS OF CEFTRIAXONE VERSUS CEFOXITIN IN REDUCING CHEST AND WOUND INFECTIONS AFTER UPPER ABDOMINAL OPERATIONS

A controlled randomized trial with blind assessment of end results is described comparing the efficacy of 1 g of intravenous ceftriaxone at induction of anesthesia with 1 g of intravenous cefoxitin (three times ) administered every 8 hours starting at induction in preventing pulmo nary and wound infection after upper abdominal operations. There were 150 adults who underwent biliary or gastroduodenal operations who were randomized to each protocol. A total of 123 patients completed the pr otocol-59 received ceftriaxone and 64 cefoxitin. Chest infection was d efined as pyrexia plus clinical and/or radiologic signs of consolidati on or the production of purulent sputum. Wound infection was defined a s purulent wound discharge. There was a significant reduction (19% ver sus 42%, P <0.05) in chest complications and in wound infection (O% ve rsus 8%, P <0.05) in the ceftriaxone group compared with the cefoxitin group. It is concluded that for biliary and gastroduodenal operations , 1 g of ceftriaxone is superior to 1 g of cefoxitin (three times) adm inistered every 8 hours and that this effect is likely to be due to th e prolonged bactericidal blood levels produced by a single dose of cef triaxone.