AMPICILLIN SULBACTAM VERSUS CEFOTETAN FOR THE PREVENTION OF INFECTIONFOLLOWING CESAREAN DELIVERY IN HIGH-RISK PATIENTS - A RANDOMIZED DOUBLE-BLIND/

The objective of this study was to compare the efficacy and safety of a single intravenous dose of 1 g ampicillin plus 0.5 g sulbactam to a single intravenous dose of 1 g cefotetan in the prevention of postoper ative infection following cesarean delivery in high-risk patients. In this single-center comparative study, women who were to undergo cesare an delivery and who were at high risk of developing postoperative infe ction were randomized into two treatment groups. At the time the umbil ical cord was clamped, one group was treated intravenously with 1 g am picillin plus 0.5 g sulbactam, and the other was treated intravenously with 1 g cefotetan. The two groups were evaluated for evidence of pos toperative infections and adverse experiences. A total of 170 women wh o were at high risk of developing postoperative infection following ce sarean delivery (87 in the ampicillin/sulbactam group and 83 in the ce fotetan group) were analyzed. Successful prophylaxis, absence of any i nfection including absence of febrile morbidity with no other symptoms , was reported in 69 of 87 (79%) patients receiving ampicillin/sulbact am and in 60 of 83 (72%) patients receiving cefotetan. One patient in each group had an infection at the incision site. There were no statis tically significant differences in the rates of endometritis or urinar y tract infections. The mean duration of hospitalization was 5.5 days for patients receiving ampicillin/sulbactam and 5.7 days for patients receiving cefotetan. A single intravenous dose of the combination of a mpicillin/sulbactam was as safe and effective as a single intravenous dose of cefotetan when administered for the prevention of infections f ollowing cesarean delivery in patients at high risk of developing post operative morbidity. Both antibiotics were safe and well tolerated wit h no unusual or unexpected events.