The American Journal of Surgery
Volume 185, Issue 1 , Pages 45-49, January 2003

A comparison of the prophylactic efficacy of ceftriaxone and cefotaxime in abdominal surgery

  • John C Woodfield

      Affiliations

    • Department of Surgery, Dunedin School of Medicine, University of Otago, P.O. Box 913, Dunedin, New Zealand
    • ,
  • Andre M Van Rij

      Affiliations

    • Department of Surgery, Dunedin School of Medicine, University of Otago, P.O. Box 913, Dunedin, New Zealand
    • Corresponding Author InformationCorresponding author. Tel.: +64-3-474-0999; fax: +64-3-474-7622.
    • ,
  • Ross A Pettigrew

      Affiliations

    • Department of Surgery, Dunedin School of Medicine, University of Otago, P.O. Box 913, Dunedin, New Zealand
    • ,
  • Antje J van der Linden

      Affiliations

    • Department of Pathology, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
    • ,
  • Clive Solomon

      Affiliations

    • Department of Surgery, Dunedin School of Medicine, University of Otago, P.O. Box 913, Dunedin, New Zealand
    • ,
  • Donna Bolt, R.N.

Received 16 October 2001; received in revised form 3 July 2002

Abstract 

Background

Although ceftriaxone (R) and cefotaxime (C) are highly effective antibiotics, few studies have directly compared their prophylactic efficacy.

Methods

In a prospective, randomized, double blind study of 1,013 patients undergoing abdominal surgery, the prophylactic use of ceftriaxone and cefotaxime were compared. Intravenous cephalosporin, 1 g, was given at induction of anesthesia, with intravenous metronidazole, 500 mg, also being given for colorectal surgery.

Results

The difference in wound infection (R 8%, C 12%, P <0.05) was due to appendicectomies not receiving metronidazole, (R 6%, C 18%, P <0.03) and was no longer present when these cases were excluded from analysis (R 8%, C 10%). Of note chest and urinary tract infection (R 6%, C 11%, P <0.02) and “any” infection (R 20%, C 27%, P <0.05) were reduced with ceftriaxone.

Conclusions

Both antibiotics provide comparable wound prophylaxis as long as metronidazole is added for colorectal and appendiceal surgery. Ceftriaxone may be more versatile having the additional apparent benefits of reducing other postoperative infections, being less dependent on metronidazole as an adjunct and providing a more effective prophylactic cover against Staphylococcus aureus.

Keywords:  Cefotaxime, Ceftriaxone, Prophylaxis, Wound infection, Chest infection, Urinary infection, Staphylococcus aureus

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PII: S0002-9610(02)01125-X

The American Journal of Surgery
Volume 185, Issue 1 , Pages 45-49, January 2003

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