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A Comparison of the Roles of Cefamandole and Ceftriaxone in Abdominal Surgery
John C. Hall, MS, FRACS;
Jane L. Hall, RN;
Keryn Christiansen, FRCPA
Arch Surg. 1991;126(4):512-516.
Abstract
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• In a prospective, randomized study, we compared the ability of ceftriaxone sodium (serum half-life, 8.0 hours) and cefamandole naftate and sodium carbonate (serum half-life, 0.8 hours) to prevent wound infection in 1238 patients undergoing abdominal surgery. Prophylaxis consisted of single-dose therapy at the time of induction of anesthesia, and treatment regimens contained ceftriaxone sodium, 1 g/d intravenously, or cefamandole naftate and sodium carbonate, 1 g intravenously every 6 hours. Except for low-risk biliary procedures, cephalosporin therapy was accompanied by the administration of metronidazole. No significant difference was noted in the incidence of wound infection, ie, 5.6% for the ceftriaxone group (95% confidence interval, 3.8% to 7.4%) and 6.9% for the cefamandole group (95% confidence interval, 4.9% to 8.9%). Single-dose prophylaxis with 1 g of cefamandole naftate and sodium carbonate was relatively inexpensive and provided a cost savings of 64%. When treatment was required, a 23% cost savings was associated with the use of a once-daily dose of 1 g of ceftriaxone sodium.
(Arch Surg. 1991; 126:512-516)
Author Affiliations
From the Departments of Surgery (Dr Hall and Ms Hall) and Microbiology (Dr Christiansen), Royal Perth (Australia) Hospital.
Footnotes
Accepted for publication August 9, 1990.
Read before the 33rd World Congress of Surgery, Toronto, Canada, September 11, 1989.
Reprint requests to the Department of Surgery, Royal Perth Hospital, Wellington Street, Perth, Western Australia, 6000, Australia (Dr Hall).
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