Ertapenem versus Cefotetan Prophylaxis in Elective Colorectal Surgery

• Published in: The New England journal of medicine Vol. 355; no. 25; pp. 2640 - 2651
• Main Authors: Itani, Kamal M.F, Wilson, Samuel E, Awad, Samir S, Jensen, Erin H, Finn, Tyler S, Abramson, Murray A
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 21.12.2006
• Subjects: Adult; Aged; Aged, 80 and over; Analysis of Variance; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Antibiotic Prophylaxis; Antibiotics; beta-Lactams - administration & dosage; beta-Lactams - adverse effects; beta-Lactams - therapeutic use; Biological and medical sciences; Cefotetan - administration & dosage; Cefotetan - adverse effects; Cefotetan - therapeutic use; Clostridium difficile; Clostridium Infections; Colorectal Surgery; Double-Blind Method; Elective Surgical Procedures; Female; General aspects; Humans; Infections; Infusions, Intravenous; Logistic Models; Male; Medical sciences; Middle Aged; Prevention and actions; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Surgery; Surgical Wound Infection - prevention & control; Treatment Failure; Medicine; Prevention; Carbapenem derivatives; Cephalosporin derivatives; Antibiotic; Cefotetan; β-Lactams; Antibacterial agent; Ertapenem; Comparative study
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa054408

With the availability of cefotetan and cefoxitin possibly ending, effective agents for wound prophylaxis during elective colorectal surgery are needed. In this large randomized, multicenter, double-blind study, ertapenem was found to be superior to cefotetan in the prevention of surgical-site infection but was associated with an increase in Clostridium difficile infection. Ertapenem was found to be superior to cefotetan in the prevention of surgical-site infection but was associated with an increase in Clostridium difficile infection. Ertapenem is a once-daily parenteral group 1 carbapenem antibiotic used in the treatment of complicated intraabdominal infection. 1 – 3 Several characteristics of ertapenem make its use attractive as a potential preoperative antimicrobial agent in elective colorectal surgery, since it is characterized by rapid intravenous administration, appropriate coverage against potential pathogens, a long half-life (so it does not require a second administration during most surgeries), and a safety profile similar to that of other commonly used antibiotics. 4 – 7 To assess the efficacy and safety of ertapenem in the prevention of surgical-site infection among patients undergoing colorectal surgery, we compared it with cefotetan, . . .