Comparative study of cefazolin, cefoxitin, and ceftizoxime for surgical prophylaxis in colo-rectal surgery

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Abstract
Ninety-two patients undergoing elective colo-rectal operations have been studied in a double-blinded, randomized trial of cefazolin, cefoxitin, or ceftizoxime for prophylaxis of postoperative surgical infection. All patients received a standard preoperative luminal neomycin-erythromycin regimen, and by random allocation, one of the three studied drugs by parenteral injection, preoperatively and for 24 h postoperatively. Side effects ascribable to one of the study drugs were infrequent and minor, and occurred in a similar frequency in all three groups. Patients who received cefoxitin (1 infection in 32 cases) or ceftizoxime (2 infections in 30 cases) had fewer wound or intraperitoneal infections postoperatively than patients who received cefazolin (4 infections in 31 cases), but the differences are not significant, and a reduction in hospitalization in patients given cefoxitin or ceftizoxime was not demonstrable. These data suggest that broader spectrum drugs such as cefoxitin or ceftizoxime may provide greater protection than cefazolin against postoperative infection on colo-rectal surgery, but a larger number of patients must be studied. Ceftizoxime is well tolerated and appears to have prophylactic efficacy for prevention of infection in colo-rectal surgery equivalent to that of cefazolin and cefoxitin.

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