Ampicillin‐Sulbactam versus Cefoxitin for Prophylaxis in High‐Risk Patients Undergoing Abdominal Surgery

Abstract

This double‐blind study compared ampicillin‐sulbactam 3 g versus cefoxitin 2 g in 136 adult patients at risk for developing an infection after abdominal surgery. Separate randomization schedules were used for colorectal, upper gastrointestinal/biliary, and other abdominal procedures. Study antibiotics were administered within 30 minutes before incision and repeated 6 hours later. Patients having colorectal surgery received a third dose of antibiotic 6 hours after the second. Efficacy evaluations were made on 123 patients, 62 in the ampicillin‐sulbactam group and 61 in the cefoxitin group. The overall postoperative infection rates were 12.9% for ampicillin‐sulbactam and 9.8% for cefoxitin (p>0.05); one wound infection occurred in each group. Adverse events were experienced by 13.2% of the ampicillin‐sulbactam and 19.1% of the cefoxitin recipients (p>0.05). Cost‐minimization analysis revealed that ampicillin‐sulbactam was a cost‐effective alternative to cefoxitin for the prevention of infection after abdominal surgery.