PROSPECTIVE RANDOMIZED CONTROLLED-STUDY OF PROPHYLAXIS WITH CEFAMANDOLE IN HIGH-RISK PATIENTS UNDERGOING OPERATIONS UPON THE BILIARY-TRACT

  • 1 January 1985
    • journal article
    • research article
    • Vol. 160  (1) , 27-32
Abstract
High risk patients (52) who underwent biliary tract operations were assigned to receive either antibiotic prophylaxis or no treatment with antibiotics. Twenty-seven patients were given 2 g of cefamandole i.m. 30 min before operation and 2 g every 8 h for 2 days postoperatively. The remaining patients were in the control group and did not receive antibiotics. Surgical wounds were inspected daily by a surgeon while the patients were in the hospital and a follow-up revision was done 4 wk after discharge from the hospital. Samples of exudate or pus were taken when the wound appeared infected and were cultured aerobically and anaerobically. Chi-square affinity test with Yate''s correction was used for statistical results; only P > 0.5 were considered significant. Seven patients (28%) in the control group had complications develop postoperatively. These were 7 surgical wound infections, 1 of which included a subphrenic abscess. Postoperatively, there were no septic complications in the group who received cefamandole prophylaxis. The incidence of infection was higher for females than males. The organisms most frequently isolated were Escherichia coli and Klebsiella. Only in 1 instance were Clostridium sporogenes found. Polymicrobial infections accounted for 42.8% of the infections. No incidences were reported with the use of cefamandole in those patients who were treated prophylactically. Apparently cefamandole is an ideal antibiotic to be used in the prophylactic treatment of infections of high risk patients who undergo operations on the biliary tract.

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