cefoxitin and Postoperative-Complications

A review of the literature indicates that cefoxitin is an effective single-agent therapy for community-acquired intra-abdominal infections, pelvic infections, and surgical prophylaxis. Hospital-acquired intra-abdominal infections may require the addition of an aminoglycoside.

Topics: Biliary Tract Diseases; Cefoxitin; Cesarean Section; Colonic Diseases; Endometritis; Female; Humans; Hysterectomy; Infection Control; Male; Postoperative Complications; Pregnancy; Puerperal Infection; Rectal Diseases

The first two known cases of Neisseria gonorrhoeae infection of a penile implant are reported. The literature regarding periprosthetic infections is reviewed, and the mode of transmission of the gonococcal organism to the corpora is discussed.

Topics: Adult; Cefoxitin; Erectile Dysfunction; Gonorrhea; Humans; Male; Middle Aged; Postoperative Complications; Prostheses and Implants; Prosthesis Failure; Tetracycline

Topics: Age Factors; Aged, 80 and over; Anti-Bacterial Agents; Antibiotic Prophylaxis; Cefoxitin; Cystectomy; Female; Fosfomycin; Humans; Male; Postoperative Complications; Prospective Studies; Treatment Outcome; Urethra; Urinary Bladder Neoplasms; Urinary Tract Infections

Acute appendicitis is the most common acute surgical disease in childhood and it still presents frequent septic complications. This prospective and randomized study compares the efficacy of two cephalosporins (cefoxitin and ceftizoxime) in terms of clinical response, in vitro activity and characteristics of use in clinical practice.. Of the 288 children with acute appendicitis admitted over a period of 15 months, 148 received cefoxitin (100 mg/kg/24 h; Group I) and 140 ceftizoxime (100 mg/kg/24 h; Group II) RESULTS: No significant differences were seen between these two groups in clinical response or infectious complication rates. In addition, activities of both antimicrobial agents against pathogens recovered from the peritoneal cultures of all patients were similar. The overall most common isolates were E. coli (75.5%), bacteroides species (33.7%) and Pseudomonas (32.4%).. We conclude that ceftizoxime is as effective as cefoxitin and can be surely employed in the treatment of acute appendicitis in children. Its addition, its longer half-life simplifies its use in clinical practice.

Topics: Acute Disease; Adolescent; Appendicitis; Bacterial Infections; Cefoxitin; Ceftizoxime; Cephalosporins; Cephamycins; Child; Child, Preschool; Female; Humans; Infant; Male; Postoperative Complications; Prospective Studies

Two prospective studies were undertaken to examine the role of bacteria in the outcome after excision and primary suture for chronic pilonidal sinus disease. In the first study 52 consecutive patients were given cloxacillin as prophylaxis. In a second randomised study 51 patients were given 2 g cefoxitin intravenously (n = 25) or no prophylaxis (n = 26). From 49 out of 98 patients (50%) no microorganisms were isolated from sinuses preoperatively. Wound complications were observed postoperatively in 61% of the patients (63/103). A postoperative bacteriology sample was positive in 47 of 49 samples (96%). Preoperative presence of bacteria was not significantly associated with wound complications. Anaerobe isolates were present in 40% of patients preoperatively whereas aerobes were cultured in 43% postoperatively. After an observation period of 30-42 months, recurrences were 13% among the patients (7/52) who had been given cloxacillin. No recurrences were seen in the last study after an observation period of 18-30 months, for an overall 7% in both studies. We conclude that preoperative bacterial isolates, usually anaerobes, in chronic pilonidal sinuses do not influence the complication rate since bacterial isolates from infected wounds are mostly aerobes.

Topics: Adolescent; Adult; Antibiotic Prophylaxis; Bacteria; Cefoxitin; Child; Chronic Disease; Cloxacillin; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Pilonidal Sinus; Postoperative Complications; Prospective Studies; Recurrence; Surgical Wound Infection

The authors present their experience from a prospective randomized study of therapeutic effects of a combination of pefloxacine (Abaktal) and klindamycin with cefoxitine in patients after hepatobiliary and pancreatic surgery. The therapeutic results in both investigated groups were evaluated in more than 95% patients as excellent, without statistically significant differences. The authors provided evidence of a comparable effectiveness of a combination of pefloxacine with klindamycin and the effectiveness of cefoxitine in patients after the above mentioned types of surgery, while treatment was cheaper when a combination of pefloxacine and klindamycin was used and moreover there was the possibility of oral administration of these preparations, as soon as the patients' condition made it possible.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Antibiotic Prophylaxis; Bacterial Infections; Biliary Tract Surgical Procedures; Cefoxitin; Clindamycin; Female; Humans; Liver; Male; Middle Aged; Pancreas; Pefloxacin; Postoperative Complications; Prospective Studies

The authors used a two-stage design to compare the risk of endometritis in women undergoing non-elective cesarean section who received cefazolin prophylaxis (n = 481) with those who received cefoxitin prophylaxis (n = 1799). The primary data source for this study was an automated record linkage system which allowed the ascertainment of exposure(antibiotic prophylaxis) and preliminary ascertainment of outcome (post-partum endometritis) on a consecutive sample of women undergoing cesarean section between 1 April 1987 and 30 September 1989. Potentially important covariates not available in the automated data source were sampled by review of complete medical records of a random sample of each exposure-disease category of the cohort. Of the 2280 women studied, 99 (4.3%) developed postpartum endometritis. After control for age, race, anemia, presence of ruptured membranes, parity, labor, number of vaginal examinations and payor status the adjusted odds ratio for cefazolin compared to cefoxitin was 0.95 (95% C.I. 0.5-1.9). The cost of prophylaxis was significantly higher for women who received cefoxitin prophylaxis ($56/patient vs $9.55/patient). These results suggest that cefazolin prophylaxis should be favored over cefoxitin due to lower cost and similar efficacy. This study also demonstrates the efficiency of a two-stage design in the setting where exposure and outcome are available for an entire cohort but information about important covariates is more difficult to obtain.

Topics: Adult; Cefazolin; Cefoxitin; Cesarean Section; Endometritis; Female; Humans; Postoperative Complications; Pregnancy; Premedication; Puerperal Infection; Research Design

In this comparative, randomized, multicenter trial, 273 patients scheduled for gynecologic surgery were studied: 87 received a single 1-g dose of cefotaxime 30 minutes before surgery; 81 were given a 1-g dose of cefoxitin 30 minutes before surgery and 1 g every 6 hours for 24 hours after surgery (total dose 4 g); and 105 received a 1-g dose of cefazolin 30 minutes before surgery, followed by 1 g every 8 hours for 48 hours (total dose 6 g). Patients who received cefotaxime had a significantly lower incidence of postoperative fever compared with those treated with cefoxitin or cefazolin (p < 0.01). The incidence of positive urinary cultures was lower in the cefotaxime and cefazolin groups when compared with the cefoxitin group (p < 0.01 and p < 0.05, respectively). The results of this study confirm the efficacy of cefotaxime as prophylaxis in surgical infections and demonstrate that single-dose cefotaxime is more effective than a four-dose regimen of cefoxitin.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cefazolin; Cefotaxime; Cefoxitin; Cephalosporins; Drug Administration Schedule; Female; Genitalia, Female; Humans; Middle Aged; Postoperative Complications; Premedication

The ideal prophylactic antibiotic regimen has not been established for patients undergoing colectomy, mucosal proctectomy, and endorectal ileoanal anastomosis, a prolonged operation frequently accompanied by abdominal and pelvic contamination and associated with an infection rate up to 20%. The aim of this study was to evaluate, in a prospective, randomized, double-blind fashion, the efficacy of a short perioperative course compared to an extended postoperative course of intravenous antibiotics (cefoxitin) in patients undergoing colectomy with ileoanal anastomosis. Forty patients with ulcerative colitis or familial polyposis coli received a mechanical and oral antibiotic bowel preparation and a standard three-dose perioperative course of intravenous cefoxitin. Patients then were randomized to receive intravenous cefoxitin, 1 g every 6 hours, or placebo for 5 days. No differences in overall postoperative morbidity were observed and neither group developed intra-abdominal, pelvic, or wound infections. It is concluded that a standard three-dose perioperative course of intravenous antibiotics provides adequate prophylaxis in the prevention of infectious complications in patients undergoing colectomy, mucosal proctectomy, and ileoanal anastomosis.

Topics: Adenomatous Polyposis Coli; Administration, Oral; Adult; Anal Canal; Anastomosis, Surgical; Cefoxitin; Colectomy; Colitis, Ulcerative; Double-Blind Method; Drug Therapy, Combination; Erythromycin; Female; Gardner Syndrome; Humans; Ileum; Infection Control; Infusions, Intravenous; Male; Neomycin; Postoperative Care; Postoperative Complications; Premedication; Prospective Studies; Rectum

The introduction of antibiotic prophylaxis for cesarean delivery has decreased the risk of postpartum endometritis and wound infection, but factors that contribute to prophylaxis failure are not understood. To determine factors that might contribute to postpartum infections following antibiotic prophylaxis, we cultured amniotic fluid, decidua, and chorioamniotic membrane specimens for anaerobic and facultative bacteria and for genital mycoplasmas at cesarean delivery. Women were assessed daily for the development of infections, and if endometritis developed, a protected endometrial culture was obtained. Postpartum endometritis developed in 16 and wound infection in four of 102 women. Infection rates were similar for women receiving cefotetan (N = 50) or cefoxitin (N = 52) for prophylaxis. The isolation of group B streptococcus (P less than .001) or Enterococcus faecalis (P = .03) from the upper genital tract at delivery was significantly associated with postpartum endometritis. Antibiotic-resistant organisms (other than enterococci) were recovered uncommonly at delivery or with postpartum infections. Group B streptococcus was susceptible to the prophylactic agents used, suggesting that virulence factors other than antibiotic resistance are important for the development of postpartum endometritis. Group B streptococcus, E faecalis, and bacteria associated with bacterial vaginosis were recovered from the endometrium at the time of postpartum endometritis.

Topics: Bacterial Infections; Cefotetan; Cefoxitin; Cesarean Section; Double-Blind Method; Endometritis; Endometrium; Extraembryonic Membranes; Female; Humans; Placenta; Postoperative Complications; Pregnancy; Premedication; Surgical Wound Infection

We report the results of a randomized, double-blind comparison of short-term versus long-term cefoxitin prophylaxis against infections after radical abdominal hysterectomy with pelvic and para-aortic lymphadenectomy. Of 113 evaluable patients, 54 (47.8%) received short-term (three doses) and 59 (52.2%) long-term (12 doses) prophylaxis with intravenous cefoxitin (2 g per dose). No significant differences in demographics, preoperative risk factors, or clinical course were detected between the two groups; nor did we detect significant differences in the incidence of surgical-site-related infections (7.4 versus 5.1%, respectively, P = .61), postoperative urinary tract infection, or other febrile morbidity. We conclude that short-term and long-term cefoxitin prophylaxis are equally effective for the prevention of post-operative surgical-site-related infections after radical hysterectomy.

Topics: Adult; Bacterial Infections; Cefoxitin; Female; Follow-Up Studies; Humans; Hysterectomy; Middle Aged; Postoperative Complications; Prospective Studies; Surgical Wound Infection; Uterine Cervical Neoplasms

This was a prospective, randomized study of 123 patients with penetrating abdominal injuries. The patients received ceftriaxone or cefoxitin for 24 h (in the presence of colonic injury, 48 h). The overall incidence of abdominal sepsis was 7.3 per cent (ceftriaxone 5 per cent, cefoxitin 9.5 per cent, P greater than 0.05). Colonic injury was the most important risk factor for the development of septic complications. Other factors, such as the weapon used, a prehospital time longer than 4 h, shock on admission, multiple organ injuries, and small bowel perforation, did not influence the incidence of sepsis.

Topics: Abdominal Injuries; Adult; Bacterial Infections; Cefoxitin; Ceftriaxone; Colon; Female; Humans; Male; Multiple Trauma; Postoperative Complications; Premedication; Prospective Studies; Risk Factors; Wounds, Penetrating

The efficacy of cefoxitin, a perioperative parenteral antibiotic, combined with mechanical bowel preparation and oral antibiotics to prevent wound infections and other septic complications in patients undergoing elective colorectal operations, was examined in a prospective randomized study. All 197 patients who completed the study received mechanical bowel preparation and oral neomycin/erythromycin base. In addition a perioperative parenteral antibiotic was given in three divided doses to 101 patients. The other 96 patients received no parenteral antibiotics. The overall incidence of intra-abdominal septic complications was 7.3% (7 of 96) in the control group (no cefoxitin) and 5% (5 of 101) in the treatment group (cefoxitin). This difference was not statistically significant. The incidence of abdominal wound infection was 14.6% in the control group and 5% in the treatment group, a statistically significant difference (p = 0.02). The addition of perioperative parenteral cefoxitin greatly reduced the incidence of wound infections in patients undergoing elective colorectal operations who had been prepared with mechanical bowel cleansing and oral antimicrobial agents.

Topics: Abscess; Administration, Oral; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Cefoxitin; Cellulitis; Colon; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Postoperative Complications; Premedication; Preoperative Care; Prospective Studies; Randomized Controlled Trials as Topic; Rectum; Surgical Wound Infection

Prophylactic effect of cefoxitin against postoperative infection at a dose of 2 g intravenous (single dose 30 minutes before the operation) was investigated using fever index in patients who underwent the elective, nonradical abdominal hysterectomy. The results obtained are summarized as follows. Total fever index values were 12.9 +/- 10.0 degree-hours in the control group (n = 39), 11.3 +/- 9.7 degree-hours in the study group (n = 39). There were no statistical significance between both groups. Data from this investigation does not suggest the concept that prophylactic antibiotics are beneficial in the reduction of postoperative infection. The results of this prospective study reflected in unnecessity of antibiotic prophylaxis in abdominal hysterectomy.

Topics: Adult; Cefoxitin; Cystitis; Female; Humans; Hysterectomy; Infection Control; Infections; Middle Aged; Parametritis; Postoperative Complications; Prospective Studies; Random Allocation; Surgical Wound Infection

To describe the microbiologic etiology of post-cesarean endometritis developing after perioperative cephalosporin prophylaxis, endometrial samples were obtained from 27 women with a triple-lumen catheter. The women were assigned in a double-blind, randomized fashion to receive either ticarcillin/clavulanate, 3.1 g, or cefoxitin, 2 g, administered every six hours, until the clinical signs of infection resolved. A total of 149 microorganisms (84 facultative and 65 obligate anaerobes) were recovered from 26 women, for a mean of 5.5 isolates per specimen. One endometrial specimen was sterile. Bacteroides and Peptostreptococcus species were the most frequent isolates, followed by Gardnerella vaginalis, Enterococcus, facultative gram-negative rods and Mycoplasma hominis. Each of the isolates was tested for beta-lactamase activity. At least one beta-lactamase-producing isolate was recovered from 56% of the specimens. Susceptibility testing of endometrial isolates demonstrated that 96% of 118 potential pathogens (Gardnerella, Bacteroides, Peptostreptococcus, enterococci and streptococci) were susceptible to ticarcillin/clavulanate. By comparison, 86% of these isolates were susceptible to cefoxitin in vitro. Women who were treated with ticarcillin/clavulanate were less likely to have a temperature greater than 38 degrees C for two or more days (8% vs. 57%, P = .01). Also, there was a trend toward a decreased duration of uterine tenderness in the ticarcillin/clavulanate group, but it did not attain statistical significance (60% vs. 86%, P = .4). However, the overall clinical success rate with these single-agent treatments was not different for the two groups (77% vs. 79%, P = 1.0).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Bacterial Infections; Bacteroides; Cefoxitin; Cephalosporins; Cesarean Section; Clavulanic Acids; Double-Blind Method; Drug Evaluation; Drug Therapy, Combination; Endometritis; Female; Humans; Penicillins; Peptostreptococcus; Postoperative Complications; Pregnancy; Randomized Controlled Trials as Topic; Ticarcillin

The purpose of this present study was to determine whether intraoperative antibiotic uterine irrigation was effective in reducing febrile morbidity (Part 1), and to determine whether ticarcillin disodium (Ticar) or cefoxitin sodium (Mefoxin) was the more effective solution (Part 2). The indications for cesarean section had an effect on febrile morbidity. In patients having nonelective cesarean section, febrile morbidity was high, occurring in 62.7% of the saline control group and 32.9% of those receiving ticarcillin disodium irrigation. In patients having elective cesarean section, febrile morbidity was lower (28% in the saline control group and 8.3% in the ticarcillin group [P less than or equal to .05]). Ticarcillin and cefoxitin were equal in reducing postoperative febrile morbidity. The use of prophylactic antibiotics, therefore, is indicated both in high-risk patients having nonelective cesarean section and in low-risk patients having elective repeat cesarean section.

Topics: Adult; Bacterial Infections; Cefoxitin; Cesarean Section; Double-Blind Method; Drug Evaluation; Female; Fever; Humans; Intraoperative Care; Penicillins; Postoperative Complications; Poverty; Pregnancy; Premedication; Puerperal Infection; Sodium Chloride; Therapeutic Irrigation; Ticarcillin; Uterus

A double-blind study was done to test the efficacy of cefoxitin in the prevention of post-cesarean-section infection. The antibiotic was given in three 2-g doses; the initial dose was given immediately after the cord was clamped, and subsequent doses were given four and eight hours later. Cefoxitin prophylaxis significantly reduced morbidity serious enough to require therapeutic antibiotics or to prolong the hospital stay and led to an overall reduction in the anaerobic microbial flora of the endocervix. However, the antibiotic was selective for the overgrowth of enterococci, which were present in nearly half the postoperative cultures of patients who had received the drug. Enterococcal sepsis occurred in one patient, and three other patients had significant bacteriuria and/or urinary tract infections from enterococci. No cefoxitin-resistant strains of Enterobacteriaceae, among species normally sensitive to the drug, were isolated from the stool samples after prophylaxis. The risk of enterococcal colonization and superinfection must be weighted against the benefits of reduction of the infection risk when deciding upon routine antibiotic prophylaxis for cesarean section.

Topics: Adolescent; Adult; Cefoxitin; Cervix Uteri; Cesarean Section; Double-Blind Method; Enterobacteriaceae Infections; Female; Humans; Postoperative Complications; Pregnancy; Prospective Studies; Randomized Controlled Trials as Topic; Superinfection

Two hundred fourteen women having vaginal or abdominal hysterectomy were entered into a prospective, randomized, blind clinical trial comparing a preoperative intravenous dose of piperacillin to three perioperative intravenous doses of cefoxitin given over an eight-hour period. Interregimen clinical, surgical, and outcome variables of the 207 evaluable subjects were statistically similar, but there were significant interprocedure differences in a variety of categories; many benefits exist when vaginal hysterectomy is possible. Efficacy of a single dose of piperacillin was similar to that of three cefoxitin doses. Seven women (3.4%) had major postoperative infection requiring parenteral antimicrobial therapy, two (1.9%) after vaginal hysterectomy and five (4.8%) after abdominal hysterectomy. Three of the latter five infections (60%) occurred after discharge from the hospital. Even with prophylaxis, postoperative anemia was associated with increased frequency of infection at the operative site after both procedures, and diabetes was associated with late infection of the abdominal incision after abdominal hysterectomy.

Topics: Adult; Bacterial Infections; Cefoxitin; Clinical Trials as Topic; Drug Administration Schedule; Female; Humans; Hysterectomy; Hysterectomy, Vaginal; Length of Stay; Middle Aged; Piperacillin; Postoperative Complications; Premedication; Prospective Studies; Random Allocation

A prospective and randomized clinical study was conducted in order to compare cefoxitin (CFX) and ceftizoxime (CZX) as prophylactic antibiotics. Two hundred and three consecutive cases of elective upper gastrointestinal tract surgery, performed at our institute between January, 1983, and March, 1986, were entered in the trial. The patients were assigned randomly, before surgery, to the CFX or to the CZX group. Two grams of the assigned antibiotic was first administered during surgery and then continued at a dose of 1 gram, every 8 hrs for a total of 4 days. One patient was withdrawn from the study due to an allergic reaction. Both groups were comparable in sex, age, underlying disease, diagnosis, operation, and preoperative laboratory data. There were 18 infections related to the operation in the CFX group, while there were only 3 in the CZX group (p less than 0.001). The number of unrelated infections in each group was 6 and 6 respectively (NS). No special differences were found between the two groups regarding the kinds of microorganisms isolated, and no significant differences were seen in the adverse effects of either antibiotic. Our study demonstrated that ceftizoxime was more efficient than cefoxitin in preventing postoperative infection, following upper gastrointestinal tract surgery.

Topics: Adult; Aged; Aged, 80 and over; Bacterial Infections; Cefoxitin; Ceftizoxime; Digestive System Surgical Procedures; Female; Humans; Male; Middle Aged; Postoperative Complications; Premedication; Prospective Studies; Random Allocation

In a multicenter study the prophylactic efficacy of two antibiotic regimens was tested against postoperative septic complications following elective colorectal surgery. The study was conducted in a prospective block-randomized design. Patients were preoperatively allocated to either ampicillin, 1 gm, four times daily, and metronidazole, 0.5 gm, three times daily, for 72 hours, or to cefoxitin, 2 gm, given three times in a period of 10 hours. Both regimens were initiated immediately before surgery. Forty-five patients were withdrawn from the study after randomization. Three hundred fifty two patients (175 receiving ampicillin and metronidazole and 177 receiving cefoxitin) completed the study and were followed for one month postoperatively. The frequency of septic and nonseptic complications was not statistically significant different between the two regimens. About one third of all septic complications appeared more than two weeks after surgery. It is concluded that short-term treatment with cefoxitin is at least as efficient as a three-day treatment with ampicillin and metronidazole.

Topics: Aged; Ampicillin; Bacterial Infections; Cefoxitin; Colon; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Male; Metronidazole; Multicenter Studies as Topic; Postoperative Complications; Premedication; Prospective Studies; Random Allocation; Rectum

In a randomised clinical trial, 102 women who underwent vaginal hysterectomy were given a single preoperative 2g dose of cefotetan (CTT) (52 pts) or three perioperative 2g doses of cefoxitin (CFX) plus 0.5g metronidazole (50 pts) as antibiotic prophylaxis. No statistically significant differences between the groups were detected in the clinical response (100% for both groups). The incidence of major wound infection (2% CTT and 0% CFX) were also comparable between the two treatment groups; post-operative changes in body temperature, duration of hospitalisation and post-operative urinary tract infections (16% CTT and 20% CFX) were similar. Both drugs were well tolerated. Twenty nine of the 102 patients were further investigated to determine the pharmacokinetics following a single 2g dose of CTT or CFX, in both serum and tissue. Although both antibiotics provided good concentrations during the early phase of surgery, CTT levels persisted for a longer time period. These results confirm that single dose cefotetan is equally as effective and safe as multiple dose cefoxitin plus metronidazole for prophylaxis in patients undergoing vaginal hysterectomy.

Topics: Adult; Aged; Bacteria, Aerobic; Bacteria, Anaerobic; Bacterial Infections; Cefotetan; Cefoxitin; Clinical Trials as Topic; Drug Therapy, Combination; Female; Humans; Hysterectomy; Hysterectomy, Vaginal; Metronidazole; Middle Aged; Postoperative Complications; Premedication; Random Allocation

The safety and efficacy of parenteral prophylaxis with either cefotetan or cefoxitin were evaluated in a prospective, randomized study of 355 subjects undergoing abdominal or vaginal hysterectomy. Each subject received either a single 1 gm dose of cefotetan intravenously 30 to 60 minutes before operation or three 2 gm doses of cefoxitin, the first 30 to 60 minutes before operation and subsequent doses 6 and 12 hours later. Prophylaxis was successful in 69 of 70 (98.6%) receiving cefotetan and 32 of 33 (97.0%) receiving cefoxitin who underwent vaginal hysterectomy. Prophylaxis was successful in 160 of 169 (94.7%) receiving cefotetan and in 79 of 83 (95.2%) receiving cefoxitin who underwent abdominal hysterectomy. Both drugs were well tolerated and without serious side effects or complications. On the basis of these findings, we conclude that a single 1 gm dose of cefotetan given before operation is as safe and effective as a multiple-dosing regimen of cefoxitin in subjects undergoing vaginal hysterectomy and in those undergoing abdominal hysterectomy at institutions where prophylaxis is indicated.

Topics: Abdomen; Adult; Cefotetan; Cefoxitin; Cephamycins; Female; Genital Diseases, Female; Humans; Hysterectomy; Hysterectomy, Vaginal; Infection Control; Middle Aged; Postoperative Complications; Prospective Studies; Random Allocation; Surgical Wound Infection

In a single-center clinical trial, a single 1 gm dose of cefotetan was as effective as a prophylactic agent as multiple 2 gm doses of cefoxitin in the prevention of postoperative infectious morbidity in women undergoing abdominal or vaginal hysterectomy. Among the 39 clinically evaluable women in the cefotetan group and 19 clinically evaluable women in the cefoxitin group, the successful clinical response rates were 97% and 95%, respectively. None of the women in either group who had vaginal hysterectomies developed postoperative complications. One woman in each group developed a major wound infection at the abdominal hysterectomy site. Although the satisfactory bacteriologic response rate was higher among the 36 bacteriologically evaluable women in the cefotetan group than among the 12 bacteriologically evaluable women in the cefoxitin group (83% versus 80%), the difference was not statistically significant. No drug-related adverse reactions were reported for any patient.

Topics: Abdomen; Adult; Cefotetan; Cefoxitin; Cephamycins; Clinical Trials as Topic; Female; Humans; Hysterectomy; Hysterectomy, Vaginal; Infection Control; Middle Aged; Postoperative Complications; Surgical Wound Infection

A prospective randomized study of 90 patients undergoing hysterectomy who received a single 1 gm dose of cefotetan and multiple 2 gm doses of cefoxitin was completed. An overall infection rate of 1.2% was recorded. Bacteriologic and clinical success rates were not different between antibiotics.

Topics: Abdomen; Adult; Aged; Cefotetan; Cefoxitin; Cephamycins; Female; Humans; Hysterectomy; Hysterectomy, Vaginal; Infection Control; Middle Aged; Postoperative Complications; Prospective Studies; Random Allocation; Surgical Wound Infection

The efficacy, safety and effect of a single, 1-g dose of ceftizoxime on the return of vaginal flora were compared to those of the standard regimen of three 2-g doses of cefoxitin for prophylaxis in 99 randomized women undergoing vaginal hysterectomy. Thirty-four were studied in Dallas and 65 in Los Angeles. Surgical procedures were comparable for all the antibiotic groups, although proportionately more simple hysterectomies were performed in Dallas. The patients received a povidone-iodine vaginal preparation immediately before surgery; vaginal packs, when used, contained no antimicrobial agents. Primary prophylactic failure (operative site infection) occurred in 1 of 52 (1.9%) and 4 of 47 (8.5%) of the ceftizoxime- and cefoxitin-treated patients, respectively, for a nonsignificant difference. All five primary prophylactic failures occurred in the Los Angeles patients. One patient in each antibiotic group developed a urinary tract infection and was classified as a secondary prophylactic failure. Febrile morbidity, length of hospital stay and incidence of adverse effects did not differ by antibiotic. The enterococcus was commonly found in the postoperative vaginal flora and was of no value in predicting operative-site infection. Enterobacter species and Pseudomonas aeruginosa were isolated more commonly in patients who received cefoxitin. Diphtheroids, Staphylococcus epidermidis and Peptostreptococcus species were isolated more commonly in patients treated with ceftizoxime.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Bacterial Infections; Cefotaxime; Cefoxitin; Ceftizoxime; Drug Administration Schedule; Female; Humans; Hysterectomy; Hysterectomy, Vaginal; Postoperative Complications; Random Allocation

Antibiotic prophylaxis in elective colonic surgery is of established value and most authors have proposed an association of at least two drugs. We have compared the efficacy of classical prophylaxis (clindamycin and gentamicin, C + G) with that of the single drug cefoxitin (Ce). 101 consecutive patients were covered; 22 had to be excluded and 7 withdrawn after randomization; 72 cases were left for final analysis (C + G 35; Ce 37). Five C + G (14.2%) and 4 Ce cases (10.8%) developed septic complications, possibly caused by opening of the colon (wound infection, anastomotic failure, colocutaneous fistula): this difference is not statistically significant. Episodes of sepsis, urinary tract infection and pneumonia were similar in both groups. Although the number of patients included is relatively small, we conclude that prophylaxis with Ce alone appears to be as effective as double drug prophylaxis with C + G.

Topics: Aged; Anti-Bacterial Agents; Cefoxitin; Clindamycin; Clinical Trials as Topic; Colectomy; Colonic Diseases; Drug Therapy, Combination; Female; Gentamicins; Humans; Intestinal Fistula; Male; Middle Aged; Postoperative Complications; Preoperative Care; Prospective Studies; Random Allocation; Surgical Wound Infection

The present study was undertaken to determine the minimal effective antibiotic dosage in caesarean section prophylaxis. The study was conducted at the Academisch Ziekenhuis der Vrije Universiteit in Amsterdam (Amsterdam Free University Hospital) to compare the efficacy of one dose of cefoxitin (2 g) with three administrations of 2, 1 and 1 g respectively. In this prospective and double-blind study, 66 patients were given one dose and 72 patients received three doses. In terms of febrile morbidity, endometritis, wound infection, urinary tract infection and need for postoperative antibiotic therapy, the three-dose group showed fewer postoperative infections: as to wound infections (p less than 0.05) and therapeutic antibiotic use (p less than 0.025) these differences were statistically significant. The numbers of days of hospitalization after the caesarean section also showed differences: 10.6 +/- 2.6 versus 9.8 +/- 1.5 days in the one- and three-dose groups respectively (p less than 0.05). It is concluded that, contrary to several reports in the literature, prophylaxis consisting of three administrations of cefoxitin is to be preferred. No significant allergic or adverse reactions were observed in our patients.

Topics: Bacterial Infections; Cefoxitin; Cesarean Section; Clinical Trials as Topic; Double-Blind Method; Drug Administration Schedule; Female; Humans; Postoperative Complications; Pregnancy; Prospective Studies; Random Allocation; Surgical Wound Infection

Topics: Administration, Oral; Cefoxitin; Clinical Trials as Topic; Colectomy; Colonic Diseases; Drug Administration Schedule; Humans; Injections, Intravenous; Neomycin; Nitroimidazoles; Postoperative Complications; Prospective Studies; Random Allocation; Rectal Diseases; Sepsis; Surgical Wound Infection; Tinidazole

Topics: Adult; Aged; Bacteriuria; Cefotetan; Cefoxitin; Clinical Trials as Topic; Drug Administration Schedule; Female; Fever; Humans; Male; Middle Aged; Postoperative Complications; Random Allocation; Surgical Wound Infection; Urologic Diseases

A randomized, double-blind comparative trial of cefoxitine and piperacillin was conducted in two groups of 30 patients with a similar number of the usual risk factors. Doses of cefoxitine 2 g and piperacillin 4 g were administered only once, except in some cases when the operation lasted more than 5 hours. Analysis of the results showed that the two antibiotics had equivalent prophylactic effectiveness (congruent to 6%) in colorectal surgery.

Topics: Abscess; Cefoxitin; Colon; Double-Blind Method; Female; Humans; Male; Piperacillin; Postoperative Complications; Premedication; Random Allocation; Rectum

Data are presented from a randomized, double-blind multicenter trial (six study sites, involving 346 patients) in which piperacillin was compared with cefoxitin as a prophylactic agent for patients undergoing cesarean section. One hundred and sixty-nine patients received piperacillin and 177 received cefoxitin; in each instance, the total dosage was 6 grams. Strict criteria were used to evaluate safety and efficacy. The courses of all of the patients were evaluable for safety and 183 courses were evaluable for efficacy (136 efficacy-evaluable courses were from patients treated with piperacillin and 147, from those treated with cefoxitin). Postoperative infection was prevented in 89 per cent of the patients treated with piperacillin and in 93 per cent of the those treated with cefoxitin. The difference was not statistically significant. The data from each of the individual study sites, as well as the pooled data, indicated that the short term perioperative administration of piperacillin in patients undergoing a cesarean section was as safe and effective as cefoxitin with regard to prophylactic response, duration of hospitalization and the usage of other systemic antibiotics.

Topics: Adolescent; Adult; Cefoxitin; Cesarean Section; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Infection Control; Piperacillin; Postoperative Complications; Pregnancy; Premedication; Random Allocation; Sterilization, Tubal

Cefoxitin, a cefamycin derivative, has demonstrated activity against a broad spectrum of aerobic and anaerobic bacterial pathogens. The efficacy and safety of cefoxitin were compared with that of the combination of clindamycin and gentamicin in the treatment of postcesarean section infection. Ninety-eight patients were evaluated. Cefoxitin cured 36 of 48 patients (75%); clindamycin/gentamicin cured 38 of 50 (76%) (P greater than .05). Febrile degree hours and length of hospital stay did not differ between the two study groups. No patient experienced abscess formation or septic pelvic thrombophlebitis. Both therapies were well tolerated. In the authors' experience, cefoxitin as a single agent was as effective in the treatment of postoperative pelvic infection as the combination of clindamycin and gentamicin.

Topics: Adult; Bacterial Infections; Cefoxitin; Cesarean Section; Clindamycin; Clinical Trials as Topic; Drug Therapy, Combination; Female; Follow-Up Studies; Gentamicins; Humans; Postoperative Complications; Pregnancy; Prospective Studies; Random Allocation; Surgical Wound Infection

168 patients undergoing acute abdominal surgery for suspected peritoneal contamination were randomized consecutively to receive either a combination of ampicillin, mecillinam and metronidazole (group I) or cefoxitin (group II). Seventy-nine patients were evaluable in group I and 69 in group II. Postoperative surgical infections were seen in a total of 17 patients, 6 in group I (7.6%) and 11 in group II (15.9%). Evaluation of potential resistance development, side-effects and a trend towards better efficacy, together with a positive cost benefit analysis, have led us to adopt the combination of ampicillin, mecillinam and metronidazole as the standard treatment in cases of acute abdominal surgery. In the 18 months following the conclusion of the study, 263 patients undergoing acute abdominal surgery were treated with the triple combination. The infection rate in this material was 4.6%.

Topics: Abdomen, Acute; Adolescent; Adult; Aged; Amdinocillin; Ampicillin; Cefoxitin; Clinical Trials as Topic; Drug Therapy, Combination; Female; Humans; Male; Metronidazole; Middle Aged; Penicillin Resistance; Postoperative Complications; Prognosis; Random Allocation; Surgical Wound Infection

A randomized, double-blind, multicenter trial was initiated to compare the safety and efficacy of piperacillin, cephalothin and cefoxitin in the prophylactic treatment of patients undergoing vaginal hysterectomy. The total dose of each antibiotic was 6 grams given in three equally divided doses. A satisfactory prophylactic response was obtained in 143 of 151 (95 per cent) patients treated with piperacillin, in 82 of 87 (94 per cent) patients treated with cephalothin and in 57 of 60 (95 per cent) patients treated with cefoxitin. The pooled data indicated that the piperacillin treatment group did not differ from the combined cephalosporin treatment groups with respect to prophylactic response, presence of febrile morbidity, fever index, duration of postoperative hospitalization and incidence of reported adverse experiences.

Topics: Adult; Aged; Aged, 80 and over; Bacterial Infections; Cefoxitin; Cephalothin; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Hysterectomy; Hysterectomy, Vaginal; Microbial Sensitivity Tests; Middle Aged; Piperacillin; Postoperative Complications; Premedication; Random Allocation

In the United States, several well-designed studies have demonstrated the efficacy of short-course antibiotic prophylaxis in cesarean sections. The present prospective study was conducted on 150 patients in a Dutch university hospital in a randomized double-blind fashion. Cefoxitin was administered according to a three-dose, 12 h regimen, the first injection given immediately after clamping of the umbilical cord. The rate of infection among the patients was significantly reduced by prophylaxis, judging from febrile morbidity, endometritis, wound infections, urinary tract infections and need for postoperative antibiotic therapy. The prophylactic use of the cefoxitin was especially effective in the secondary cesarean section population. Three risk factors significantly correlated with increased risk of infection: labor, rupture of membranes and pelvic examination. Postoperative cervical cultures showed a significant reduction of bacteria in the cefoxitin group. No shift towards resistant pathogens was demonstrable.

Topics: Adult; Bacterial Infections; Cefoxitin; Cesarean Section; Double-Blind Method; Female; Humans; Postoperative Complications; Pregnancy; Premedication; Prospective Studies; Random Allocation; Risk

A prospective, double-blind study was performed to evaluate the comparative efficacy of single- and multiple-dose antimicrobial prophylaxis for preventing infection in high-risk patients undergoing cesarean section. One hundred fifty-eight patients were randomly assigned to receive either a single perioperative dose of mezlocillin, three doses of mezlocillin or three doses of cefoxitin. The incidence of endometritis was 5.9%, 4.0% and 4.0%, respectively. The incidence of febrile morbidity was 5.9%, 2.0% and 6.1%, respectively. These differences are not statistically significant. The single perioperative dose of mezlocillin was as effective as the three-dose regimen of either mezlocillin or cefoxitin.

Topics: Adult; Bacterial Infections; Cefoxitin; Cesarean Section; Double-Blind Method; Endometritis; Female; Humans; Mezlocillin; Postoperative Complications; Pregnancy; Premedication; Prospective Studies; Random Allocation; Urinary Tract Infections

Multiple studies have shown that the incidence of infectious complications after penetrating abdominal wounds are decreased by the perioperative administration of antibiotics. In this study of three separate single cephalosporin agents (cefotaxime, cefoxitin, and moxalactam) given for a 48 hour period in patients who sustained perforating gastrointestinal wounds, uncomplicated recoveries occurred in 93 percent of all patients. The rates of uncomplicated recovery were significantly different for the three groups; however, patients with major intraabdominal vascular injuries were more common in the cefoxitin-treated group. One disturbing feature was the presence of enterococci in 57 percent of isolates from wound infections and 60 percent of isolates from intraabdominal abscesses. Enterococci as sole isolates were found in one of two wound infections and three of four intraabdominal abscesses in the moxalactam-treated group.

Topics: Abdominal Injuries; Adult; Cefotaxime; Cefoxitin; Drug Evaluation; Female; Humans; Male; Moxalactam; Postoperative Complications; Prospective Studies; Random Allocation; Wound Infection; Wounds and Injuries

A double-blind, placebo-controlled trial was performed to assess the value of cefoxitin for prophylaxis against postoperative infection following radical hysterectomy. Infectious morbidity was observed in 35% of 43 patients in the control group and 23% of 31 in the cefoxitin group. In seven control patients (16%) and one patient (3%) in the cefoxitin group the infections were related to the surgical site (p = 0.07). These differences did not achieve statistical significance. Examination of the data revealed a number of other factors, including operating time, patient weight, blood loss, and blood replacement, that were significantly related to the incidence of infectious morbidity. Comparison of the results of the present study with those in the literature indicates that a careful examination of the circumstances prevailing in any particular institution is necessary before a decision is made on strategies to combat infectious morbidity after radical hysterectomy.

Topics: Adult; Bacterial Infections; Cefoxitin; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Hysterectomy; Length of Stay; Middle Aged; Postoperative Complications; Premedication; Surgical Wound Infection

Twenty-three patients (22 male and 1 female) aged 41 to 70 years (mean age 56.4 years) with cancer of the upper respiratory and digestive tracts were entered into the study prior to a major surgical procedure involving incision of cervical mucous membranes. Participants were randomly assigned either to a control group (10 patients) which received no routine intra or postoperative antibiotics, or to a treatment group (13 patients) given cefoxitin perioperatively. Treated patients were given 30 mg/kg cefoxitin intravenously over 30 mn, one hour before surgery was begun, and 30 mg/kg over one hour, 3 hours and 6 hours after the initial infusion was started. Rate of local infection was 80% (8/10) and 15% (2/10) in the control group and treated group respectively (p less than 0.001). In addition, a significant difference in rates of local complications was found: 7 disjunctions and/or fistulae or pharyngostomes in the control group against one suppuration with disjunction in the treated group. In the treated group, a mean 24.6 day reduction in time lapse to cicatrization was observed. Fever greater than or equal to 39 degrees C occurring or persisting beyond the 48th postoperative hour was also significantly more frequent in the control group (7/10 versus 3/13). In contrast, no significant difference was found between rates of other infectious localizations. Local bacterial flora recovered in both groups before and/or after surgery was unremarkable and prophylactic cefoxitin selected no particular pathogens.

Topics: Adult; Aged; Bacterial Infections; Cefoxitin; Digestive System Neoplasms; Drug Evaluation; Female; Humans; Male; Middle Aged; Postoperative Complications; Respiratory Tract Neoplasms

Fifty women were randomly given one, two, or three 2 gm parenteral doses of cefoxitin with placebo blinding perioperatively at abdominal hysterectomy. A single preoperative intramuscular dose was more efficient, less frequently associated with the development of bacterial resistance, and less expensive than two or three doses.

Topics: Bacterial Infections; Cefoxitin; Clinical Trials as Topic; Double-Blind Method; Drug Resistance, Microbial; Female; Humans; Hysterectomy; Postoperative Complications; Premedication

Piperacillin has been shown to be as safe and effective an agent as cephalothin and cefoxitin when used in patients undergoing elective intra-abdominal surgical procedures. Enterococcus species have been shown in other studies to be susceptible to piperacillin, perhaps making it the preferred antibiotic for prophylaxis in clinical settings when enteric flora will be encountered.

Topics: Abdomen; Bacterial Infections; Cefoxitin; Cephalothin; Clinical Trials as Topic; Double-Blind Method; Drug Evaluation; Female; Humans; Male; Piperacillin; Postoperative Complications; Preoperative Care; Surgical Wound Infection

In a prospective trial conducted at five medical centres, 136 patients aged 18 to 75, undergoing elective gastro-intestinal surgery were randomized to receive a single dose of cefotaxime, 1 g preoperatively, or cefoxitin, 2 g preoperatively followed by 2 g every 6 h for no more than 24 h. Overall infection rates with both regimens were approximately 10%. There were no significant differences in the infection rates between subgroups. Thus, a single preoperative 1 g dose of cefotaxime is as efficacious as, but considerably more cost-effective than, multiple 2 g doses of perioperative cefoxitin in the prevention of infection following elective gastrointestinal tract surgery.

Topics: Adolescent; Adult; Aged; Cefotaxime; Cefoxitin; Digestive System Surgical Procedures; Female; Humans; Male; Middle Aged; Postoperative Complications; Premedication

In a randomized, single-blind study, the efficacy of single-dose cefotaxime was compared with multiple dose cefoxitin in genitourinary surgery prophylaxis. Patients received either 1.0 g cefotaxime before surgery; or 2.0 g cefoxitin pre-operatively and every 8 h for no more than 24 h post-operatively. Of the evaluable patients receiving cefotaxime 3 of 35 (8.6%) became infected post-operatively, compared to 12 of 37 (32.4%) patients receiving cefoxitin (P less than 0.01). It is concluded that single-dose genitourinary surgical prophylaxis with cefotaxime may be more effective than a longer dosing schedule with cefoxitin in the prevention of post-operative urinary tract infections, and that a single-dose regimen may represent significant cost containment advantages for hospitals.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cefotaxime; Cefoxitin; Female; Humans; Male; Middle Aged; Postoperative Complications; Premedication; Urogenital System

One hundred one women undergoing elective abdominal hysterectomy were given perioperative cefoperazone or cefoxitin in a prospective randomized blinded study. Both regimens were well tolerated and no significant toxic or allergic manifestations were observed. Interrelationships between antimicrobial concentration in serum and pelvic tissues, intraoperative cardinal ligament cultures, febrile morbidity, and major postoperative infection were determined. At uterine removal, mean cefoperazone concentrations in serum (56.1 micrograms/mL) and pelvic tissues (18.6 micrograms/g) were significantly higher than mean concentrations of cefoxitin, ie, 16.1 micrograms/mL and 8.1 micrograms/g, respectively (P less than .001). The incidence of major postoperative infection was 6% or less with both regimens. Perioperative prophylaxis significantly reduced the incidence of this infection. When it did develop, however, it continued to cause significant morbidity, prolonging hospital stay a mean of more than four days (P less than .001) and increasing the hospital bill a mean of almost $1500 (P less than .001).

Topics: Adult; Bacterial Infections; Cefoperazone; Cefoxitin; Clinical Trials as Topic; Female; Fever; Humans; Hysterectomy; Middle Aged; Postoperative Complications; Premedication; Prospective Studies; Random Allocation

In this randomized, double-blind study, the effectiveness of a single-agent prophylactic antibiotic in reducing infections after radical abdominal hysterectomy with pelvic and para-aortic lymphadenectomy was compared with a placebo. A total of 12 doses of cefoxitin (2g) or placebo were given to 70 patients, starting the evening before surgery. Because of tumor spread beyond the cervix, radical hysterectomy was not performed in 17 patients who were, therefore, excluded from the study. Analysis of 53 patients who completed the study revealed that 15% of cefoxitin patients had surgical site-related infections compared with 52% of placebo patients (P = .005). Significant differences between the groups were also observed in nonsurgical site-related infections (23 versus 48%), overall morbidity (58 versus 89%), and the need for additional antibiotic therapy (38 versus 67%). Socioeconomic status was a significant risk factor with 57% of staff patients demonstrating increased site-related infections as compared with 17% of private patients (P = .002). No clinically significant side effects were observed. The authors recommend the use of antibiotic prophylaxis in patients undergoing radical abdominal hysterectomy for gynecologic malignancies.

Topics: Adult; Aged; Anti-Bacterial Agents; Bacterial Infections; Cefoxitin; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Hysterectomy; Lymph Node Excision; Middle Aged; Pneumonia; Postoperative Complications; Premedication; Random Allocation; Risk; Socioeconomic Factors; Surgical Wound Infection; Urinary Tract Infections

From 1979 through 1981, 152 patients with penetrating injuries of the intra-abdominal gastrointestinal tract were placed on one of three different perioperative antibiotic regimens in a prospective randomized fashion. The three regimens were A) cefamandole 2 grams every 4 hours, B) cefoxitin 2 grams every 6 hours, and C) ticarcillin 3 grams every 4 hours and tobramycin 1.5 mg/kg every 8 hours. Antibiotics were administered intravenously before and for 48 hours following surgical exploration and repair. The three treatment groups were similar with respect to age, average number of organ injuries, and distribution of organ injuries. Cefoxitin-treated patients experienced uneventful recoveries more often than cefamandole-treated patients (94% vs. 80.3%, p less than 0.05) when the incidence of gram-negative wound infection and intra-abdominal abscess formation was considered, while the number of patients who experienced uneventful recoveries in the ticarcillin-tobramycin group was not statistically different from the other two groups of patients. Bacteroides fragilis was isolated from three of the six abscesses occurring in the cefamandole-treated group, while no anaerobes were isolated from abscesses in patients treated with either of the other two regimens. The results of this study suggest that the most effective perioperative antibiotic regimen for patients with penetrating gastrointestinal wounds should possess activity against both aerobic and anaerobic flora of the bowel.

Topics: Abdomen; Abdominal Injuries; Abscess; Adult; Anti-Bacterial Agents; Cefamandole; Cefoxitin; Clinical Trials as Topic; Female; Humans; Male; Postoperative Complications; Premedication; Prospective Studies; Random Allocation; Surgical Wound Infection; Ticarcillin; Tobramycin; Wounds, Penetrating

The aerobic and anaerobic cervical microflora was determined before operation and on day 4 after operation in groups of women undergoing a clinical trial of prophylaxis with three doses of cefoxitin, cefazolin, or placebo for infectious complications of nonelective cesarean section. Floral shifts occurred post partum, with return of Escherichia coli and Bacteroides fragilis and a decrease in Candida colonization. No significant differences in flora existed preoperatively among patients receiving cefoxitin, cefazolin, or placebo, but by day 4, both antibiotic groups had greater enterococcal colonization. This difference was more marked with cefoxitin than with cefazolin. No difference in E. coli or B. fragilis colonization was noted by day 4 in placebo and antibiotic groups. Resistance developing in isolates in the antibiotic groups was mainly a result of enterococcal colonization. Results of this study indicate that a three-dose cephalosporin prophylactic regimen resulted in a significant selection of resistant enterococcal colonization but there was no increase in nosocomial infection in the antibiotic groups compared to the placebo group. There did not appear to be significant differences in either species selection or antibiotic resistance of aerobic or anerobic microflora between the cefoxitin and cefazolin groups.

Topics: Bacteria, Aerobic; Bacteria, Anaerobic; Cefazolin; Cefoxitin; Cervix Uteri; Cesarean Section; Clinical Trials as Topic; Double-Blind Method; Drug Resistance, Microbial; Female; Humans; Infection Control; Postoperative Complications; Pregnancy; Random Allocation

A randomized double-blind placebo-controlled comparison of prophylactic cefoxitin, an antibiotic with good activity against anaerobic bacteria, with cefazolin, an agent effective predominantly against aerobes, was undertaken in 354 women who underwent nonelective cesarean section (124 receiving cefoxitin, 119 cefazolin, and 111 placebo). Among the placebo group, 24.3% developed genital tract-related infection, in comparison to 5.6% of the cefoxitin patients and 6.7% of the cefazolin patients (P less than 0.001). Standard febrile morbidity, fever index, and duration of postoperative hospital stay were also significantly less in the antibiotic prophylactic groups. For patients with febrile morbidity, the mean fever index was less in the cefoxitin group (24.8 degree-hours) than that in the cefazolin group (42.7 degree-hours), and this difference approached statistical significance (P less than 0.1, greater than 0.05). Postoperative hospital stay longer than 1 week for infectious morbidity occurred in 26% of cefoxitin patients, a significantly lower incidence compared to the 66% rate for patients who received cefazolin, and the 57% incidence for patients in the placebo group (P less than 0.05).

Topics: Adult; Bacterial Infections; Cefazolin; Cefoxitin; Cesarean Section; Clinical Trials as Topic; Double-Blind Method; Female; Fever; Genital Diseases, Female; Humans; Infant, Newborn; Length of Stay; Postoperative Complications; Pregnancy; Premedication; Random Allocation

Our evaluation consisted of a prospective, randomized clinical trial in a homogenous group of 241 patients undergoing elective colon and rectal resections. A significant decrease in wound infection was found in the patients who received intravenous cefoxitin in conjunction with standard bowel preparation. The infection rate correlated with the type of resection; rectal resections had the highest rate in each study group, but parenteral prophylaxis produced a significantly lower wound infection rate. E. coli and Staph. aureus were the most common bacterial isolates in both groups. B. fragilis was recovered in only two Group A patients, which most likely reflects the exceedingly low recovery rate of anaerobic bacteria in our laboratory. Urinary cultures were positive in a large number of patients and reflect the standard use of Foley catheterization in all patients who undergo resection of the colon or rectum. These data indicate that perioperative prophylactic administration of cefoxitin reduces the wound sepsis rate when combined with oral antibiotics and mechanical bowel preparation in patients undergoing resection of the colon or rectum.

Topics: Administration, Oral; Adolescent; Adult; Aged; Anti-Bacterial Agents; Cefoxitin; Clinical Trials as Topic; Colon; Drug Therapy, Combination; Female; Humans; Infusions, Parenteral; Male; Middle Aged; Postoperative Complications; Prospective Studies; Random Allocation; Rectum; Risk; Wound Infection

A prospective, blinded, placebo-controlled study was performed to determine the minimum effective duration of short-term antibiotic prophylaxis following cesarean section. Cefoxitin was selected as the study drug, and 189 women at high risk for postoperative infectious morbidity were randomly assigned to three cohorts, each receiving intravenous infusions at cord clamping and at 4 and 8 hours postoperatively. The incidence of endometritis in the placebo group was 29.3% versus 9.4% in patients receiving one dose of cefoxitin (2 gm) at cord clamping and 5.0% in patients receiving three doses of cefoxitin (p less than 0.0001). Cefoxitin prophylaxis significantly reduced the incidence of endometritis in patients with postoperative anemia. There were no serious complications or drug reactions in the treated groups.

Topics: Adult; Cefoxitin; Cesarean Section; Clinical Trials as Topic; Double-Blind Method; Drug Administration Schedule; Endometritis; Female; Humans; Postoperative Complications; Pregnancy; Pregnancy Complications, Infectious; Prospective Studies; Random Allocation; Risk

The effectiveness of prophylactic cefoxitin in preventing postcesarean section infection was studied in a high risk population. One hundred women were evaluated, and on a random double-blind basis 50 received placebo and 50 received cefoxitin. There were three doses of drug given intravenously, either placebo or 1 gram of cefoxitin at the time of cord clamping and again four and eight hours later. Those receiving cefoxitin had significantly less postoperative infections, fewer had bacteremia and there was less postoperative fever as measured by the fever index. The patient with the most protracted infection in this study received cefoxitin. Problems with the use of systemic antibiotic prophylaxis in preventing postcesarean section infection are discussed. Cefoxitin is an effective agent to use in patients undergoing cesarean section who are at high risk for infection.

Topics: Adult; Cefoxitin; Cesarean Section; Clinical Trials as Topic; Endometritis; Female; Humans; Mexico; Postoperative Complications; Pregnancy; Premedication; Prospective Studies; Puerperal Infection; Random Allocation

The effectiveness of antibiotic irrigation in reducing post-cesarean section infectious morbidity was studied in a prospective, randomized, double-blind trial. One hundred twenty-eight patients were divided into three groups and irrigated with either cefoxitin solution, cephapirin solution, or saline. Following delivery of the placenta, the uterine cavity and incision, bladder flap, pelvic gutters, and subcutaneous tissue of the patients were irrigated. There was a significant reduction in total infectious morbidity (p less than 0.02) and wound infection (p less than 0.04) when antibiotic use was compared to the saline control. No statistical difference in the effectiveness of the two antibiotics could be demonstrated. No adverse effects were noted. Antibiotic irrigation is a safe and effective method in reducing infectious morbidity of the parturient patient.

Topics: Bacterial Infections; Cefoxitin; Cephalosporins; Cephapirin; Cesarean Section; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Intraoperative Care; Postoperative Complications; Pregnancy; Prospective Studies; Random Allocation; Surgical Wound Infection; Therapeutic Irrigation

A retrospective chart analysis of women undergoing elective abdominal hysterectomy in Parkland Memorial Hospital indicated significant postoperative antibiotic administration. For that reason, we conducted a prospective, double-blind, placebo-controlled study to determine the incidence of infection and febrile morbidity in this patient population and to evaluate the efficacy of perioperative cefoxitin in modifying the incidence of these conditions. Three 2 gm intramuscular doses of cefoxitin over 12 hours significantly reduced the incidence of major infection to 12% from 32% observed in the placebo group. The mean hospital stay for women given cefoxitin (5.6 days) was also significantly reduced when compared to that for women given placebo (6.4 days). The incidence of febrile morbidity not requiring therapy was significant and was not altered by perioperative cefoxitin. Febrile morbidity was observed in 42% of women given cefoxitin and in 34% of women given placebo. Administration of perioperative antimicrobial agents is necessary for women undergoing elective abdominal hysterectomy in our hospital, but we believe that individual determination is required.

Topics: Adolescent; Bacterial Infections; Cefoxitin; Cellulitis; Clinical Trials as Topic; Double-Blind Method; Female; Fever; Humans; Hysterectomy; Length of Stay; Pelvic Inflammatory Disease; Postoperative Complications; Premedication; Prospective Studies; Random Allocation

We performed a randomized, double-blind trial on a relatively low-risk population comparing the use of three doses of cefoxitin vs. placebo in the prevention of infection following primary cesarean section. Major site-related morbidity (endometritis, wound infection and septicemia) was significantly reduced in the cefoxitin group (8.9% vs. 27.8%; p = 0.017). Febrile morbidity alone tended to occur in the cefoxitin group (15.6% vs. 3.7%; p = 0.091), and all five urinary tract infections occurred in the cefoxitin group as well. Total morbidity was therefore not significantly different (cefoxitin, 35.6%; placebo, 31.5% [not significant]). Duration of hospitalization (mean, 6.0 days) and need for further postoperative antibiotic therapy were similar in the two groups. Our study demonstrated a modest benefit from the perioperative use of antibiotics in relatively low-risk patients undergoing primary cesarean section. Issues that need further study include definition of the optimal prophylactic regimen and of high-risk populations for whom prophylaxis would be most helpful.

Topics: Adult; Cefoxitin; Cesarean Section; Clinical Trials as Topic; Double-Blind Method; Endometritis; Female; Fever; Humans; Placebos; Postoperative Complications; Pregnancy; Premedication; Sepsis; Surgical Wound Infection; Urinary Tract Infections

A prospective, randomized, double-blind clinical study was performed to determine the efficacy of perioperative systemic antibiotics in preventing infection after appendectomy for acute nonperforating appendicitis. One hundred three patients received three doses of either placebo (saline, n = 52) or cefoxitin sodium (n = 51). The two groups were similar with regard to age distribution, sex ratio, duration of operation, pathologic condition of appendix, and hospital stay. Postoperative wound infections were detected in 9.6% of the placebo-treated patients, whereas none occurred in the cefoxitin group. All but one infection appeared after discharge. Cost analysis identified a net savings of $ 84 per patient with the use of prophylactic antibiotics. Septic morbidity after appendectomy for nonperforating appendicitis is significantly reduced by systemic antibiotics, and brief administration of a single broad-spectrum agent (cefoxitin) is effective prophylaxis.

Topics: Adolescent; Adult; Aged; Appendicitis; Cefoxitin; Child; Child, Preschool; Cost-Benefit Analysis; Double-Blind Method; Female; Humans; Intraoperative Care; Male; Middle Aged; Postoperative Complications; Prospective Studies; Random Allocation; Wound Infection

The efficacy of cefoxitin or doxycycline as antibiotic prophylaxis in colorectal surgery was compared in 102 elective operations. Both drugs were used perioperatively only. Cefoxitin was used in 55 cases and doxycycline in 47. Ten patients in the cefoxitin group and 4 in doxycycline group had wound infections. Three intraabdominal abscesses were seen, one after cefoxitin and two after doxycycline prophylaxis. All three were due to anastomotic leakage. Bacteriologic studies revealed no negative ecologic effects of prophylaxis. The short-term prophylaxis used did protect against serious infectious complications. The extended spectrum of cefoxitin provided no added benefit in prophylaxis. Patients with inflammatory bowel disease treated preoperatively with salicylazosulfapyridine run a greater risk of postoperative infection in spite of the prophylaxis.

Topics: Adult; Aged; Cefoxitin; Colonic Diseases; Crohn Disease; Doxycycline; Female; Humans; Male; Middle Aged; Postoperative Complications; Prospective Studies; Random Allocation; Rectal Diseases; Sulfasalazine; Surgical Wound Infection

The Authors illustrate the results obtained in treatment of various types of infection in patients hospitalised in an intensive care surgical department with cephoxitin, a new semisynthetic antibiotic derivate of the cephalosporin group. In view of the severity of the treated cases, the Authors consider the results obtained to be satisfactory.

Topics: Adult; Aged; Bacterial Infections; Cefoxitin; Clinical Trials as Topic; Cross Infection; Female; Humans; Intensive Care Units; Male; Middle Aged; Postoperative Complications; Respiratory Tract Infections; Surgical Wound Infection; Urinary Tract Infections

Topics: Adult; Aged; Cefoxitin; Clinical Trials as Topic; Digestive System Surgical Procedures; Double-Blind Method; Female; Humans; Infection Control; Intraoperative Care; Male; Middle Aged; Postoperative Complications

Topics: Adult; Aged; Cefoxitin; Clinical Trials as Topic; Digestive System Surgical Procedures; Double-Blind Method; Female; Humans; Infection Control; Intraoperative Care; Male; Middle Aged; Postoperative Complications

This prospective study was designed to compare the relative efficacy of two antibiotic regimens for the treatment of operative site infections subsequent to pelvic operations. Patients with endomyoparametritis after delivery or pelvic cellulitis subsequent to hysterectomy were randomized to treatment with the combination of penicillin-gentamicin or the single agent cefoxitin. Seventeen of the 26 patients (65%) with endomyoparametritis who were treated with penicillin-gentamicin were cured by antibiotic therapy alone, in comparison to 15 of 23 (65%) patients treated with cefoxitin. Fifty-eight percent of the patients with pelvic cellulitis who were treated with penicillin-gentamicin responded favorably, in comparison to 50% of the patients treated with cefoxitin. None of these differences was statistically significant. In this study, neither antibiotic regimen provided satisfactory initial treatment for surgically induced soft tissue pelvic infection. Moreover, 11 of the 28 patients with treatment failures (40%) developed serious sequelae of their primary infection.

Topics: Bacterial Infections; Cefoxitin; Cesarean Section; Clindamycin; Clinical Trials as Topic; Delivery, Obstetric; Drug Therapy, Combination; Endometritis; Female; Gentamicins; Humans; Hysterectomy; Infant, Newborn; Parametritis; Penicillins; Peptococcus; Postoperative Complications; Pregnancy; Prospective Studies; Puerperal Infection; Staphylococcal Infections; Streptococcus agalactiae

Ninety-one patients were enrolled in a prospective randomized double-blind study evaluating the efficacy of systemic antibiotic prophylaxis in reducing the incidence of operative site infection after abdominal hysterectomy. Forty-five patients received a 2-dose course of cefoxitin; 46 patients received a placebo. Although patients in the antibiotic group had a lower fever index, there were no statistically significant differences between groups with respect to incidence of pelvic cellulitis, urinary tract infection, wound infection, need for therapeutic antibiotics, or duration of hospitalization. It is concluded that, in this patient population, the theoretic risks of widespread use of systemic antibiotics for prophylaxis outweigh the observed benefits.

Topics: Adult; Anti-Bacterial Agents; Cefoxitin; Clinical Trials as Topic; Cystitis; Double-Blind Method; Female; Humans; Hysterectomy; Parametritis; Postoperative Complications; Premedication; Random Allocation

Prophylactic cefoxitin was evaluated in 101 patients undergoing cesarean section. A three-dose regimen of either cefoxitin or placebo was administered randomly in a double-blind manner, 46 patients receiving cefoxitin and 55 placebo, with the first dose given after the cord was clamped. In the placebo group, 29% of the patients developed pelvic or wound infection, compared to 4% in the cefoxitin group (P less than 0.003). No patient required re-operation, re-admission, or had a life threatening infection. Ten risk factors for infection were analyzed to help ascertain which patients would benefit from prophylaxis. Cefoxitin, with a broad spectrum of aerobic and anaerobic coverage, was found to be an effective and safe prophylactic agent when given to all patients undergoing cesarean section.

Topics: Adult; Cefoxitin; Cesarean Section; Double-Blind Method; Endometritis; Female; Humans; Postoperative Complications; Pregnancy; Random Allocation; Surgical Wound Infection

Cefoxitin was administered parenterally in doses of 2 g, every six hours for two days, to 20 patients undergoing colorectal surgery. Blood and fecal specimens were obtained for five days for analysis of cefoxitin concentrations. Tissue samples from the gut wall were obtained at surgery. The maximum serum concentrations during surgery varied between 25 and 100 microgram/ml, and the cefoxitin concentrations for the fecal samples were 1.5-35 microgram/g and for the tissue samples, 2.0-50 microgram/g. Fecal samples for cultivation of aerobic and anaerobic bacteria were also obtained daily during the first five days, and after 14 day after operation. Pronounced changes in the microflora occurred during the investigation period. Among the aerobic bacteria, cefoxitin-sensitive Escherichia coli and other enterobacteria decreased markedly while cefoxitin-resistant enterococci, Pseudomonas and Enterobacter proliferated during the antibiotic prophylaxis period. Among the anaerobic bacteria, Bacteroides fragilis and other Gram-negative bacteria decreased significantly. However, after the antibiotic administration period, all cefoxitin-resistant strains decreased while the suppressed E. coli and B. fragilis strains increased. In one patient, a minor postoperative infection caused by a cefoxitin-resistant strain of Pseudomonas aeruginosa was observed.

Topics: Adult; Aged; Anaerobiosis; Bacteria; Bacterial Infections; Cefoxitin; Clinical Trials as Topic; Colon; Female; Humans; Male; Middle Aged; Postoperative Complications; Premedication; Preoperative Care; Rectum

The efficacy of cefoxitin, either alone or in combination (+/-) with an aminoglycoside was compared with clindamycin plus (+), an aminoglycoside for the treatment of mixed aerobic-anaerobic surgical infections, in a prospective randomized single blinded study. One hundred patients were entered into the study; 37 patients were assessable for clinical outcome in both groups, while toxicity could be assessed in 46 patients in the cefoxitin group and 47 in the clindamycin group. The groups were evenly matched considering age, sex, and type of infection. Favorable clinical responses were achieved in 34 of 37 patients treated with cefoxitin +/- amikacin, and 29 of 37 patients treated with clindamycin + amikacin; there was no statistical difference between the groups (p greater than 0.1). The incidences of toxicity were the same. Our study has demonstrated that cefoxitin with or without an aminoglycoside is as effective as clindamycin plus an aminoglycoside in the therapy of serious mixed infections in surgical patients.

Topics: Adolescent; Adult; Aged; Amikacin; Bacterial Infections; Cefoxitin; Clindamycin; Clinical Trials as Topic; Drug Therapy, Combination; Female; Humans; Kanamycin; Male; Middle Aged; Postoperative Complications; Prospective Studies

A double-blind, controlled trial was performed to assess the effect of a short intraoperative course of Cefoxitin, a new broad spectrum cephamycin antibiotic, on the incidence of septic complications following elective colonic and rectal surgery. In addition to a two-day preoperative bowel preparation, patients entered in the study received a short course of either Cefoxitin (three 2g intravenous bolus doses at two-hour intervals, the first before skin incision) or a matching placebo. Thirty-two patients received Cefoxitin and 33 patients received the placebo. Postoperative abdominal wound infections developed in one (3%) of the Cefoxitin-treated patients and nine (27%) of the placebo-treated patients. This difference is statistically significant (p = 0.01). Septic complications remote from the abdominal wound, e.g. intra-abdominal abscesses, occurred in both Cefoxitin-treated and placebo-treated patients, but numbers were too small for meaningful analysis. The study shows that even a very short peroperative course of Cefoxitin is highly effective in reducing postoperative abdominal wound infections after elective colorectal surgery.

Topics: Adult; Aged; Bacterial Infections; Cefoxitin; Clinical Trials as Topic; Colon; Double-Blind Method; Female; Humans; Intraoperative Period; Male; Middle Aged; Postoperative Complications; Premedication; Rectum; Surgical Wound Infection

Topics: Abdomen; Adult; Aged; Bacterial Infections; Cefoxitin; Cephalosporins; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Postoperative Complications

To evaluate the effect of cefoxitin prophylactic in reducing the incidence of severe infection after transrectal prostate biopsy (TRPB).. This retrospective study included 155 cases of TRPB with a 5-day administration of oral levofloxacin at 200 mg bid (the control group) and another 167 cases with a 3-day administration of oral levofloxacin at the same dose plus intravenous cefoxitin at 2.0 g 2 hours before TRPB (the experimental group) according to the distribution characteristics of drug-resistance bacteria in our department. The patients of the control and experimental groups were aged (68.68 ± 8.12) and (68.72 ± 7.51) years, with PSA levels of (19.78 ± 21.57) and (21.15 ± 42.63) μg/L, involving (11.68 ± 1.44) and (11.77±1.02) biopsy cores, respectively. Comparisons were made between the two groups of patients in the incidence rate of severe infection, which was defined as lower urinary track symptoms plus the systemic inflammatory response syndrome (SIRS) within 7 days after TRPB.. The incidence rate of postoperative severe infection was significantly lower in the experimental group than in the control (0.6% ［1/167］ vs 5.8% ［9/155］, P < 0.05). Blood cultures revealed positive E-coli strains in 6 cases in the control group, including 5 ESBL-positive and 4 quinolone-resistant and amikacin-sensitive cases, all sensitive to cefoxitin, cefoperazone/sulbactam and imipenem. The only one case of severe infection was shown to be negative in blood culture.. Preoperative intravenous administration of cefoxitin according to the specific distribution characteristics of drug-resistance bacteria can significantly reduce the incidence of severe infection after TRPB.. 目的: 通过分析本中心耐药菌特点，调整预防性抗菌药物治疗方案，降低经直肠穿刺活检后严重感染并发症发生率。方法: 本研究为回顾性研究，将2011年1月至2013年12月间于我院按既往抗菌药物预防方案行经直肠前列腺穿刺活检患者共155例作为对照组，抗菌药物方案为穿刺前日晚起口服乳酸左氧氟沙星分散片，每日2次，每次200 mg，穿刺后继续口服3 d。通过分析本中心耐药菌分布特点，2015年5月至2017年7月于我院行经直肠列腺穿刺活检并接受联合抗菌药物方案的患者167例，设为试验组，抗菌药物方案为穿刺前日晚起口服乳酸左氧氟沙星分散片，每日2次，每次200 mg，至穿刺后第2日停用，穿刺前2 h静脉滴注头孢西丁钠2 g。两组肠道准备方式相同。对照组和试验组患者的年龄分别为(68.68±8.12)岁和(68.72±7.51)岁，PSA水平分别为(19.78±21.57) μg/L和(21.15±42.63) μg/L。所有患者均采用超声引导下10针及以上经直肠前列腺穿刺活检，对照组和试验组患者穿刺针数分别为(11.68±1.44) 针和(11.77±1.02) 针。将严重感染定义为穿刺后1周内出现下尿路症状合并全身炎症反应综合征，分析两组患者穿刺后严重感染的发生率。结果: 对照组和试验组术后严重感染发生率分别为 5.8% (9/155)和0.6% (1/167)，差异有统计学意义(P<0.05)；对照组中血培养6例阳性，均为大肠埃希菌，其中5例为产超广谱β内酰胺酶菌株（ESBL+），6例血培养阳性患者中，对氟喹诺酮类抗菌药物均耐药，阿米卡星敏感者4例，6例患者头孢西丁、头孢哌酮舒巴坦、亚胺培南均敏感。试验组1例严重感染患者血培养阴性。结论: 根据本中心耐药菌分布特点，经直肠前列腺穿刺活检前加用单剂量头孢西丁预防感染可降低术后严重感染发生率。.

Topics: Aged; Anti-Bacterial Agents; Biopsy; Cefoxitin; Drug Resistance, Bacterial; Escherichia coli; Escherichia coli Infections; Humans; Levofloxacin; Male; Middle Aged; Postoperative Complications; Prostate; Retrospective Studies

This paper aims to observe the effect of Shenqi Fuzheng Injection combined with cefoxitin sodium after cesarean section. Clinical data of 126 puerperae were retrospectively analyzed. They randomized into control group and treatment group, and there were 63 cases in each group. Patients in control group were given Cefoxitin Sodium treatment. And patients in treatment group were given Shenqi Fuzheng Injection on the basis of control group. After 7 days of treatment, the clinical curative effect of the two groups was observed and compared. The body temperature of the patients in treatment group was significantly decreased when compared with control group on the 2nd and 3rd day after operation (P<0.05); the first exhaust time and defecation time of patients in treatment group were significantly shortened when compared with control group (P<0.05); the postoperative hemoglobin and red blood cell count in both groups were all significantly increased when compared with before treatment (P<0.05), and the treatment group were evidently higher than control group (P<0.05); the postoperative neutrophilic granulocyte percentage, white blood cell count and lymphocytes percentage in both groups were all significantly lowered when compared with before treatment (P<0.05), and the neutrophilic granulocyte percentage, white blood cell count and lymphocytes percentage in treatment group were significantly lowered when compared with control group (P<0.05). Shenqi Fuzheng injection combined with cefoxitin sodium after cesarean section can effectively reduce the postoperative maternal body temperature and promote the recovery of maternal gastrointestinal function, which is conducive to the repair of uterus, further correct anemia after cesarean section and prevent postpartum infection. Its clinical curative effect is ideal, with certain clinical application value.

Topics: Adult; Anti-Bacterial Agents; Body Temperature Regulation; Cefoxitin; Cesarean Section; Defecation; Drug Therapy, Combination; Drugs, Chinese Herbal; Female; Humans; Injections; Postoperative Complications; Pregnancy; Randomized Controlled Trials as Topic; Recovery of Function; Retrospective Studies; Time Factors; Treatment Outcome; Uterus; Young Adult

Topics: Aged; Anti-Bacterial Agents; Bacteremia; Bacterial Proteins; beta-Lactam Resistance; beta-Lactamases; Catheter-Related Infections; Cefoxitin; Cross Infection; Diarrhea; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Enterococcus faecalis; Glycopeptides; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Pancreatic Neoplasms; Pneumonia, Bacterial; Postoperative Complications; Prostatitis; Substrate Specificity; Urinary Catheterization

In a retrospective study comparing 526 oocyte donors who received prophylactic antibiotics for oocyte retrieval with a comparable group of 625 who did not, the incidence of infection after retrieval was reduced from 0.4% to 0 in the group receiving antibiotics. Donors take risks but have no medical indication for the procedures that they undergo; our data suggest that prophylactic antibiotics at retrieval should be considered to minimize the risk of infection.

Topics: Adult; Anti-Infective Agents, Local; Antibiotic Prophylaxis; Cefoxitin; Clindamycin; Female; Humans; Oocyte Donation; Oocyte Retrieval; Pelvic Infection; Postoperative Complications; Reproductive Techniques, Assisted; Retrospective Studies; Sepsis; Triclosan; Young Adult

Topics: Antibiotic Prophylaxis; Bacterial Infections; Cefoxitin; Drug Administration Schedule; Family; Humans; Intestine, Small; Living Donors; Postoperative Complications; Transplantation, Homologous; Vancomycin

Topics: Aged; Antibiotic Prophylaxis; Cefoxitin; Cephamycins; Enterocolitis, Pseudomembranous; Humans; Hysterectomy, Vaginal; Male; Postoperative Complications

Topics: Aged; Ampicillin; Blood Platelet Disorders; Cefoxitin; Hematoma; Hemoperitoneum; Humans; Male; Postoperative Complications; Shock; Surgical Wound Infection

Safety and efficacy were evaluated and compared retrospectively in 77 patients who received cefotetan (CTN) and 51 patients who received cefoxitin (CFX) for surgical prophylaxis. Both groups were similar with respect to age and gender. Surgical procedures were similar between groups (e.g., obstetric/gynecologic, renal transplant, colon, exploratory laparotomy, gastroduodenal, hernia repair). Postoperative infectious complications were more common in the CTN group (11.6 percent [9/77]) than in the CFX (7.8 percent [4/51]) group; however, this difference was not statistically significant. A higher incidence of wound infections was noted in the CTN group (5.2 percent [4/77]) than in the CFX group (2.0 percent [1/51]); this difference was also not significant. Patients receiving immunosuppressive therapy were more likely to develop infectious complications when CTN was used for prophylaxis (p = 0.0001). Clinically significant blood loss was not noted during surgery. Elevations in prothrombin times (greater than 1 sec) occurred in 27.3 percent (3/11) of CTN and 11.1 percent (1/9) of CFX patients (not significant). Except for the small subset of patients receiving concomitant immunosuppressive therapy, CTN appeared to be as safe and effective as CFX when used for surgical prophylaxis. Although not statistically significant, the increased incidence of wound infections in the CTN-treated patients requires further study in a prospective randomized comparison.

Topics: Adult; Cefotetan; Cefoxitin; Drug Evaluation; Female; Humans; Male; Postoperative Complications; Premedication; Retrospective Studies; Surgical Wound Infection

Topics: Aged; Antibiotic Prophylaxis; Biliary Tract Surgical Procedures; Cefotetan; Cefoxitin; Controlled Clinical Trials as Topic; Female; Humans; Male; Postoperative Complications; Risk Factors; Sepsis; Surgical Wound Infection

Infections after oesophageal surgery are studied on sixty patients who received perioperatively two antibiotics (cefoxitin and amikacin). Postoperative infection rate is 62% (pneumopathies: 27%, leakage of cervical anastomoses: 17%). Different parameters which can induce postoperative infection are analyzed. The only significative data are the duration of total parenteral nutrition and of intensive care stay. The commonest isolated organisms are gram negative bacilli (61%) and streptococci (30%). Yeasts infections are frequent, and significantly correlated with antibiotic treatment duration.

Topics: Aged; Amikacin; Bacterial Infections; Cefoxitin; Esophageal Diseases; Female; Gram-Negative Bacteria; Humans; Lung Diseases; Male; Middle Aged; Parenteral Nutrition; Postoperative Complications; Premedication; Prospective Studies; Urinary Tract Infections

Cefoxitin is a bactericidal beta lactam antibiotic of the cephamycins group, with wide antimicrobial efficacy and active against both aerobes and anaerobes. In this study, 58 patients were divided in four groups according to the site of the disease (stomach, gallbladder and biliary tract, jejunum ileum and colon-rectum). The efficacy of cefoxitin in the prophylaxis of surgical infections was assessed for each group and for all patients. When compared with the combination of antibiotics used previously, cefoxitin led to a reduction of the mean duration of fever (7.2 and 5 days respectively with ampicillin/cloxacillin and lincomycin/gentamycin, 3.2 days with cefoxitin). Cefoxitin also led to a reduction in the incidence of surgical infections (50% with ampicillin/cloxacillin, 9.19% with lincomycin/gentamycin, 8.6% with cefoxitin) and in the incidence of localized surgical infections (29.6%, 20.3%, 8.6% respectively). In this study, cefoxitin has been found to be very useful and well tolerated in the prophylaxis of surgical infections.

Topics: Adult; Aged; Aged, 80 and over; Bacterial Infections; Cefoxitin; Digestive System Diseases; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Postoperative Complications; Premedication; Risk Factors

Infective complications are often seen in colorectal surgery. These even occur in cases of elective surgery and in patients where adequate bowel preparation has been performed and is due to the very high numbers of bacteria colonising the bowel. Several controlled clinical studies showed that antimicrobial prophylaxis is effective in preventing infective complications and the lack of prophylaxis is no longer justified. Antimicrobial prophylaxis can be oral (poorly absorbed antibiotics aimed to reduce the number of bacteria in the bowel) or systemic (aimed to reach a high tissue concentration when bacterial contamination occurs, in order to prevent colonisation) or a combination of the two. Which is to be preferred is still controversial. Systemic prophylaxis should have the following features: 1) use of a single agent with a broad spectrum of action, effective both on aerobes and anaerobes; 2) rapid I.V. administration, at the beginning of surgery; 3) good tissue penetration; 4) long half-life, in order to assure that the single dose will cover the whole duration of surgery; 5) good therapeutic ratio. The use of long half-life cephalosporins, particularly cefotetan, was shown to be highly beneficial. Prophylaxis can fail if contamination during surgery is severe, with a particularly high bacterial count. The degree of contamination of the operating field can be evaluated both by surgeon's judgment, and by tissue or peritoneal cavity lavage fluid sampling and culture. In case of severe contamination (bacterial number greater than 10(5) CFU/ml of fluid or mg of tissue) prolonging of antibiotic therapy for some days is justified. Otherwise, no evidence supports its prolongation beyond surgery.

Topics: Anti-Bacterial Agents; Bacterial Infections; Cefotetan; Cefoxitin; Colon; Female; Humans; Intraoperative Period; Male; Postoperative Complications; Premedication; Random Allocation; Rectum; Surgical Wound Infection

Topics: Adult; Aged; Aged, 80 and over; Bacterial Infections; Cefoxitin; Ceftriaxone; Female; Humans; Male; Middle Aged; Postoperative Complications; Premedication; Risk Factors; Stomach Diseases

Topics: Adult; Bacterial Infections; Cefamandole; Cefonicid; Cefoxitin; Cesarean Section; Cost-Benefit Analysis; Female; Humans; Postoperative Complications; Pregnancy

The third day temperature is frequently used in the decision whether to continue or terminate antibiotic treatment following appendicectomy in perforated appendicitis. To assess the value of the third day temperature in predicting intraperitoneal infectious complications we studied 235 consecutive patients treated with a 3-day course of cefoxitin after surgery for perforated appendicitis. The results demonstrated that regardless of the level of elevated temperature chosen, the predictive value ranged between 16 and 33%. In consequence, elevated third day temperature per se does not provide any rational basis for continuing antibiotic treatment in order to prevent intraperitoneal infectious complications following appendectomy in perforated appendicitis.

Topics: Abdomen; Abscess; Adolescent; Adult; Aged; Aged, 80 and over; Appendectomy; Appendicitis; Body Temperature; Cefoxitin; Child; Child, Preschool; Drug Administration Schedule; Female; Humans; Intestinal Perforation; Male; Middle Aged; Postoperative Complications; Surgical Wound Infection; Time Factors

Colostomy closure has also today a complication rate between 20 and 30% in the literature, in which infectious complications are playing a substantial role. Increasing experience and standardization as well as better preoperative treatment, like whole gut irrigation and perioperative antibiotics and the additional use of a Gentamicin-PMMA-chain, led to a distinct reduction of the postoperative complication rate in a prospective study of 40 colostomy closures.

Topics: Adult; Aged; Aged, 80 and over; Cefoxitin; Colon; Colonic Diseases; Colostomy; Drug Therapy, Combination; Female; Gentamicins; Humans; Male; Methylmethacrylates; Middle Aged; Postoperative Complications; Premedication; Preoperative Care; Rectum; Surgical Wound Infection; Therapeutic Irrigation

Topics: Cefoxitin; Hemorrhage; Humans; Moxalactam; Postoperative Complications

New third generation cephalosporins have been recommended as single agent antibiotic therapy in the treatment of postoperative infections. This study compares the new third generation cephalosporin ceftizoxime with cefoxitin, clindamycin and gentamicin in the treatment of postcesarean section endomyometritis. The results indicate that the clindamycin and gentamicin regimen is more efficacious in the treatment of severe infection after cesarean section than either ceftizoxime or cefoxitin regimens. Therefore, the results of this study suggest caution in substituting single drug antibiotic therapy with cefoxitin or the third generation cephalosporins for the standard clindamycin and gentamicin regimen in the treatment of postcesarean section endomyometritis until more clinical data are available.

Topics: Adult; Cefotaxime; Cefoxitin; Ceftizoxime; Cervix Uteri; Cesarean Section; Clindamycin; Drug Therapy, Combination; Endometritis; Escherichia coli; Female; Gentamicins; Humans; Postoperative Complications; Pregnancy; Streptococcus agalactiae; Streptococcus pyogenes

The authors, after stating the results of their clinical experience on 50 patients subjected to antibiotic prophylaxis with cefoxitin on the occasion of surgical operations on abdomen, compare the results of the antibiotic prophylaxis after a short time with those of the prophylaxis-therapy after an average time.

Topics: Abdomen; Adolescent; Adult; Aged; Bacterial Infections; Cefoxitin; Female; Humans; Male; Middle Aged; Postoperative Complications; Premedication; Time Factors

This clinical trial was designed to evaluate the efficacy, safety and patient tolerance of cefoxitin (CFS) in 46 patients who were admitted to the hospitals from June 1983 to April 1984. The daily doses of CFX for 34 patients (ages ranged from 6 to 75 years old) were 2 to 8 g to prevent the infections and for 12 patients (ages ranged from 55 to 81 years old) were 2 to 6 g to treat the infections by intravenous drip infusion 1 or 3 times a day in divided doses. The following results were obtained. All of 34 patients with intracranial operation who received CFX for prevention of postoperative infections showed good results. Of 12 patients with postoperative pneumonia, infections of urinary tract and late meningitis, 11 patients showed good results. One patient was discontinued on the 3 days because of the drug eruption which improved 3 days after. The side effect was noted in only 1 patient. This was eruption which improved 3 days after the stop of the administration. The influences to the laboratory data due to CFX were not recognized. The results of this study demonstrated that CFX was an excellent drug for the prevention and treatment of the postoperative infections in the neurosurgical field because of high efficacy rate and safety.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Brain Diseases; Cefoxitin; Child; Female; Humans; Infusions, Parenteral; Male; Middle Aged; Pneumonia; Postoperative Complications; Premedication; Urinary Tract Infections

This article describes a case of disseminated Mycobacterium chelonei infection in a renal transplant recipient. This patient, who underwent thoracic duct drainage prior to cadaveric renal transplantation, developed M chelonei bacteremia and numerous subcutaneous nodules a few weeks after transplantation. The M chelonei initially responded to amikacin and tetracycline. Because of side effects and bacterial resistance, however, these drugs had to be discontinued. Subsequent treatment with cefoxitin led to reduction in size of subcutaneous nodules, but control of the infection was not achieved until an intravascular nidus of infection at the anastomotic site of an arteriovenous fistula was removed.

Topics: Adult; Cadaver; Cefoxitin; Drug Resistance, Microbial; Female; Humans; Kidney Transplantation; Mycobacterium; Mycobacterium Infections; Postoperative Complications

In 63 patients, who underwent handsurgery under tourniquet ischemia, 2 g of Cefoxitin were given i.v. The antibiotic levels in tissue and serum at different times were obtained using biological assay. The results area compared with cefoxitin-concentrations of samples from abdominal surgery. By means of regression-analysis the tissue-serumquotient is defined as the relation of function to the time. The model-character of the conditions unter tourniquet ischemia is described.

Topics: Adipose Tissue; Biological Availability; Carpal Tunnel Syndrome; Cefoxitin; Dupuytren Contracture; Humans; Muscles; Postoperative Complications; Premedication

Ten patients (8 with moderate or severe infections, 2 for prevention of postoperative infections) were treated with cefoxitin. The patients were given cefoxitin of 2 approximately 9 g, given once, or in 2 approximately 3 divided doses. Clinical efficacy was good in 7 cases, fair in 2 and poor in 1. Transient nausea and vomiting occurred in 1 patient when a direct intrauterine injection (1 g of cefoxitin) was given, however, no side effects were observed in the other patients. The result of this study demonstrates that cefoxitin when given massively is effective in achieving bacteriologic and clinical cure in treatment of infections and for prevention of postoperative infections in the field of obstetrics and gynecology.

Topics: Adult; Bacterial Infections; Cefoxitin; Cesarean Section; Female; Genital Diseases, Female; Humans; Infusions, Parenteral; Middle Aged; Postoperative Complications; Pregnancy; Premedication; Puerperal Infection

Topics: Adult; Aged; Bacterial Infections; Cefoxitin; Evaluation Studies as Topic; Female; Genital Diseases, Female; Humans; Middle Aged; Postoperative Complications; Premedication

A total of 16 hospitalized patients underwent surgery for gastroenterological problems in the Department of Gastroenterological Surgery, Kanazawa Medical College Hospital, during the period from April 1981 to September 1981. After they had undergone partial or total gastroenterological resection, cefoxitin was administered for the prevention of postoperative infections. The following findings were obtained. 1. Fifteen out of 16 patients responded well with the clinical efficacy of 94 percent. 2. Elevations in S-GOT levels were noted in 3 patients. However, no other abnormalities were evident in the clinical data. 3. These clinical results indicate that cefoxitin is an effective antibiotic for the prevention of postoperative infections in gastroenterological surgery.

Topics: Adult; Aged; Bacterial Infections; Cefoxitin; Cholelithiasis; Female; Gastrectomy; Humans; Male; Middle Aged; Postoperative Complications; Stomach Neoplasms; Surgical Wound Infection

A total of 20 hospitalized patients underwent orthopedic surgery in the Tokyo Metropolitan Police Hospital during the period from December 1981 to March 1982. These patients were treated with cefoxitin, mainly, for the prevention of postoperative infections. The following clinical findings were obtained. 1. Out of the 20 patients, 14 were judged 'good' and 6 'fair'. 2. No side effects were reported by the patients or were evident in the clinical data. 3. These clinical results indicated that cefoxitin is a very effective antibiotic for the prevention of postoperative infections in orthopedic surgery.

Topics: Adult; Aged; Bacterial Infections; Cefoxitin; Drug Evaluation; Female; Humans; Male; Middle Aged; Postoperative Complications; Premedication

Twenty one cases of appendiceal peritonitis in children are reviewed. An antibiotic (sodium cefoxitine) has been used during the post-operative course to decrease the risk of suppurative complications. Cultures obtained from peritoneal exudate yielded "E. coli" and "Bacteroides" sp. as the most commonly isolated bacteria. External drainage was placed as a rutine and the percentage of suppurative complications was 14%. No patient showed evidence of adverse reactions to the antibiotic and the mortality of the serie was zero. Obtained results allow to state that cefoxitine is effective in the management of appendiceal peritonitis in children.

Topics: Appendicitis; Ascitic Fluid; Cefoxitin; Child; Drainage; Humans; Peritonitis; Postoperative Complications; Rupture, Spontaneous

Topics: Bacterial Infections; Cefoxitin; Female; Humans; Male; Middle Aged; Postoperative Complications

Eleven patients with cholesteatoma undergoing surgical procedures were treated with cefoxitin. The following findings were obtained: 1. Eight out of 11 patients' responses were judged "good" and the remaining 3 were judged "fair" with a cure rate of 72.7%. 2. No untoward side effects and abnormalities in laboratory findings were noted on cefoxitin. 3. Cefoxitin should be considered for the treatment of cholesteatoma undergoing surgical procedures because it is well tolerated, has a broad spectrum of antibacterial activity against both Gram-positive and Gram-negative pathogens including anaerobes.

Topics: Adolescent; Adult; Cefoxitin; Child; Cholesteatoma; Drug Evaluation; Ear Diseases; Ear, Middle; Female; Humans; Male; Middle Aged; Postoperative Complications; Premedication; Surgical Wound Infection

Topics: Anti-Bacterial Agents; Bacterial Infections; Cefoxitin; Cefuroxime; Humans; Lung Diseases; Postoperative Complications; Respiratory Tract Infections; Surgical Procedures, Operative

Cefoxtin sodium is a new semisynthetic cephamycin antibiotic derivative of cephamycin-C. It has a broad antibacterial spectrum in vivo and in vitro that includes all strains of cephalosporin-sensitive bacteria and the majority of cephalosporin-resistant bacteria. A double-blind (cefoxitin and placebo) study was instigated in premenopausal women undergoing vaginal hysterectomy at Louisiana State University Gynecologic Service. There were 152 patients, of whom 125 completed the study. The objective of the study was to determine the clinical effectiveness of cefoxitin as a safe prophylactic antibiotic. Both placebo and cefoxitin groups were from the authors' clinic, and thus there were no major clinical differences among patients. The cefoxitin-treated group had a 10.3% major morbidity as compared to 29.8% in the placebo group. Cefoxitin was well tolerated and there were no adverse reactions in any of the patients.

Topics: Adult; Bacterial Infections; Cefoxitin; Cervix Uteri; Double-Blind Method; Female; Humans; Hysterectomy; Hysterectomy, Vaginal; Placebos; Postoperative Complications; Vagina

To determine the unbiased incidence and types of postoperative infection and their alteration(s) by antimicrobial prophylaxis, a prospective double-blind study was performed using perioperative intramuscular cefoxitin or placebo given to premenopausal women undergoing vaginal hysterectomy at Parkland Memorial Hospital. The clinical and surgical profiles of the 2 groups of women were similar, but there were marked differences in their postoperative clinical courses. Only 8% of the 50 women given cefoxitin had major postoperative infection, compared to 57% of the 49 women given placebo (P < .001); this was associated with a 2.8-day reduction in the hospital stay for those given cefoxitin (P < .001). No clinically significant side effects were observed.

Topics: Adult; Bacterial Infections; Cefoxitin; Double-Blind Method; Female; Hospitalization; Humans; Hysterectomy, Vaginal; Menopause; Middle Aged; Placebos; Postoperative Complications; Premedication; Prospective Studies

Cefoxitin was given to the 7 patients of infections in the field of obstetrics and gynecology, and the following results were obtained: 1) The clinical response was excellent in 2 patients, good in 4 and poor in 1 patient with the efficacy rate of 85.7%. Out of the 4 patients resistant to the previous therapy with other antibiotics, 3 patients responded to cefoxitin, and all the 3 patients of anaerobic infections responded satisfactorily to cefoxitin. 2) Microorganisms isolated were 2 strains each of E. coli and Staphylococcus aureus, 3 strains of Peptococcus and 1 strain of Eubacterium lentum. All the 8 strains isolated were sensitive to cefoxitin. As to bacteriological response, all the strains isolated were eradicated except 1 strain of Staphylococcus aureus which recurred on the 9th day after completion of the therapy with the eradication rate of 87.5%. 3) No subjective nor objective side effects were noted. Especially, the elevated GOT and GPT observed on a patient complicated with hepatitis prior to the initiation of cefoxitin treatment were found to be normal upon completion of the treatment.

Topics: Abdominal Muscles; Adult; Aged; Cefoxitin; Cesarean Section; Female; Fistula; Genital Diseases, Female; Humans; Middle Aged; Parametritis; Pelvic Inflammatory Disease; Postoperative Complications; Pregnancy; Pyelitis; Wound Infection

Topics: Anaerobiosis; Anti-Bacterial Agents; Bacterial Infections; Brain Diseases; Cefoxitin; Clindamycin; Gastrointestinal Diseases; Humans; Metronidazole; Penicillins; Postoperative Complications; Respiratory Tract Infections