Faculty Collaboration Database

Infectious complications after 809 biliary tract operations and results of a prospective randomized single-blind study comparing cefoxitin versus ampicillin plus an inhibitor of beta-lactamases. Infection 1990;18(1):41-7

Date

01/01/1990

Pubmed ID

2179137

DOI

10.1007/BF01644184

Scopus ID

2-s2.0-0025097828 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

A retrospective analysis of 809 biliary tract operations revealed postoperative wound infections in 13.4% of 278 patients with bactericholia, compared to 6.9% in patients without bactericholia. More than one third of isolated bacteria were resistant to ampicillin. This was the basis to conduct a prospective randomized single-blind study to compare the efficacy of ampicillin in combination with the beta-lactamase-inhibitor sulbactam with cefoxitin as perioperative prophylaxis in elective biliary surgery. Patients received a single dose of either 2 g ampicillin plus 1 g sulbactam or 2 g cefoxitin as intravenous short-infusion approximately 30 min prior to skin incision. Both groups were comparable concerning demographic and nosographic data. 80 of 83 patients were evaluable for efficacy; 39 received ampicillin/sulbactam and 41 cefoxitin. In the cefoxitin group two wound infections were observed. In the ampicillin/sulbactam group one patient developed postoperative temperatures of greater than 39.0 degrees C, which was regarded as a wound-related infectious complication. In addition, there occurred five urinary tract infections (cefoxitin: 3; ampicillin/sulbactam: 2) but no pulmonary infection. In conclusion, no significant difference between the two groups could be shown. Both regimens were well tolerated with no significant differences between treatment groups. The combination of ampicillin with the beta-lactamase-inhibitor sulbactam can be regarded as safe and as effective compared to cefoxitin for single-dose prophylaxis of post-operative infections after biliary tract operations.

Author List

Wittmann DH, Koltowski P, Oleszkiewicz J, Walker AP

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Ampicillin
Biliary Tract Surgical Procedures
Cefoxitin
Female
Humans
Length of Stay
Male
Middle Aged
Prospective Studies
Randomized Controlled Trials as Topic
Single-Blind Method
Sulbactam
Surgical Wound Infection
beta-Lactamase Inhibitors
beta-Lactamases