Comparison of cefotetan and cefoxitin prophylaxis for abdominal and vaginal hysterectomy

• Published in: American journal of obstetrics and gynecology Vol. 158; no. 3 Pt 2; p. 706
• Main Authors: Berkeley, A S, Freedman, K S, Ledger, W J, Orr, J W, Benigno, B B, Gordon, S F, McGregor, J A, Galask, R P, Sevin, B U
• Format: Journal Article
• Language: English
• Published: United States 01.03.1988
• Subjects: Abdomen; Adult; Cefotetan; Cefoxitin - administration & dosage; Cefoxitin - therapeutic use; Cephamycins - administration & dosage; Cephamycins - therapeutic use; Female; Genital Diseases, Female - prevention & control; Humans; Hysterectomy; Hysterectomy, Vaginal; Infection Control; Middle Aged; Postoperative Complications - prevention & control; Prospective Studies; Random Allocation; Surgical Wound Infection - prevention & control
• ISSN: 0002-9378
• DOI: 10.1016/S0002-9378(16)44531-X

The safety and efficacy of parenteral prophylaxis with either cefotetan or cefoxitin were evaluated in a prospective, randomized study of 355 subjects undergoing abdominal or vaginal hysterectomy. Each subject received either a single 1 gm dose of cefotetan intravenously 30 to 60 minutes before operation or three 2 gm doses of cefoxitin, the first 30 to 60 minutes before operation and subsequent doses 6 and 12 hours later. Prophylaxis was successful in 69 of 70 (98.6%) receiving cefotetan and 32 of 33 (97.0%) receiving cefoxitin who underwent vaginal hysterectomy. Prophylaxis was successful in 160 of 169 (94.7%) receiving cefotetan and in 79 of 83 (95.2%) receiving cefoxitin who underwent abdominal hysterectomy. Both drugs were well tolerated and without serious side effects or complications. On the basis of these findings, we conclude that a single 1 gm dose of cefotetan given before operation is as safe and effective as a multiple-dosing regimen of cefoxitin in subjects undergoing vaginal hysterectomy and in those undergoing abdominal hysterectomy at institutions where prophylaxis is indicated.