[Antibiotic prophylaxis in abdominal surgery].

Abstract

In order to compare the efficacy of antibiotic therapy using Cefalozin or Cefotaxime, 3,137 patients operated with an abdominal approach were included into a multidepartmental prospective study by lot. The patients were distributed into 4 levels according to the degree of intraoperative contamination and to the risk factors they presented. The patients in each level were distributed by lot into three treatment groups: 1) Cefalozin, 2) Cefotaxime, 3) no treatment. The antibiotics were delivered perioperatively in 3 doses of 1 g every eight hours. The patients having had colic surgery or operated for peritonitis were excluded from the study. The number of intestinal wall abscesses was significantly lower in the treated groups, except in level 3 (contaminated surgery). The percentage of postoperative peritonitis was twice lower in the treated groups than in the control group. There was no difference between the treated groups. The patients included in the treated groups were given significantly less antibiotics than the patients of the control group. As far as costs are concerned, antibiotic prophylaxis with Cefalozin is effective in all procedures of abdominal surgery in which the degree of contamination by anaerobes is low.