cefamandole and Gastrointestinal-Hemorrhage

Acceptance of the value of antibiotic prophylaxis in gastroduodenal surgery is growing, but only one controlled, double-blind study justifying this is available. In this second, controlled, randomized, double-blind study 60 patients underwent urgent and elective gastroduodenal operations. Among 32 patients receiving cefamandole perioperatively for prophylaxis, only 1 subsequently had a wound infection, but wound infections occurred in 8 of the 28 patients who received a placebo (P less than 0.01). Infection rates were higher in contaminated wounds and in urgent operations than in clean-contaminated wounds and elective surgery. The results confirm the value of antibiotic prophylaxis in this setting.

Topics: Cefamandole; Cephalosporins; Clinical Trials as Topic; Double-Blind Method; Female; Gastrointestinal Hemorrhage; Gastrointestinal Neoplasms; Humans; Male; Middle Aged; Peptic Ulcer; Premedication; Random Allocation; Surgical Wound Infection

Antibiotics can be associated with hypoprothrombinaemic haemorrhages in risk patients. Risk factors are: poor nutrition, impaired liver- or renal function, coagulation depleting medical therapy or illness. Pathogenetically there is a vitamin K deficiency with reduction of vitamin K dependent clotting factors; mainly by decreased vitamin K synthesis in intestinal bacterias. In consequence every risk patient under antibiotics should receive vitamin K prophylactically and in a parenteral way, because of unreliable resorption in gastrointestinal tract. Prothrombin-time-monitoring is essential to recognize the hypoprothrombinemia in every risk patient under antibiotics.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Appendicitis; Cefamandole; Diverticulitis, Colonic; Female; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Hypoprothrombinemias; Intestinal Perforation; Male; Ornidazole; Postoperative Complications; Premedication

Topics: Blood Coagulation Disorders; Cefamandole; Gastrointestinal Hemorrhage; Humans

Topics: Cefamandole; Gastrointestinal Hemorrhage; Humans

Topics: Bacteria; Cefamandole; Cephalosporins; Depression, Chemical; Gastrointestinal Hemorrhage; Humans; Intestines; Vitamin K; Vitamin K Deficiency