Cefazolin is As Effective and is Less Expensive Than latamoxef as prophylaxis in elective biliary surgery A double-blind study was conducted to compare the prophylactic efficacy of a single dose of cefazolin with that of latamoxef [moxalactam] in patients undergoing elective gallbladder and associated biliary tract surgery. 72 evaluable women and 18 men with no preoperative signs of biliary sepsis or significant underlying diseases were randomly assigned to receive, within 1 hour before anaesthesia, a single dose of IV cefazolin 1 g (n = 45) or IV latamoxef 1 g (45) over 20-30 min. Plasma, bile and gallbladder levels of the 2 drugs were not significantly different. Bile cultures from 6/ 45 cefazolin recipients isolated 12 organisms and from 3/45 latamoxef recipients yielded 5 pathogens, predominantly Escherichia coli and Enterococci. Recent cholecystitis, common bile duct exploration, diabetes mellitus and the type of antibiotic used were not predictive of positive bile cultures. Age > 65 years was the only independent predictive factor (p < 0.001 ). Postoperative wound infections occurred in 2 cefazolin recipients and in 1 latamoxef recipient; the organisms recovered from the wound cultures were different to those recovered in the bile cultures. The authors concluded that a single dose of either cefazolin or latamoxef was equally effective prophylactically and both were well tolerated. Cefazolin, with its lower cost and narrower antimicrobial spectrum making microbial resistance less likely, is favoured as the standard antibiotic prophylaxis 1n elective biliary surgery. Kellum JM, Duma RJ, Gorbach SL. Sugerman HJ. Haynes Jr BW. el al Arch1ves of Surgery 122 918-922, Aug 1987 12 INPHARMA® 19 December 1987 0156-2703/87/1219-0012/0$01.00/0 © ADIS Press

Cefazolin is As Effective and is Less Expensive

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Cefazolin is As Effective and is Less Expensive Than latamoxef as prophylaxis in elective biliary surgery

A double-blind study was conducted to compare the prophylactic efficacy of a single dose of cefazolin with that of latamoxef [moxalactam] in patients undergoing elective gallbladder and associated biliary tract surgery. 72 evaluable women and 18 men with no preoperative signs of biliary sepsis or significant underlying diseases were randomly assigned to receive, within 1 hour before anaesthesia, a single dose of IV cefazolin 1 g (n = 45) or IV latamoxef 1 g (45) over 20-30 min.

Plasma, bile and gallbladder levels of the 2 drugs were not significantly different. Bile cultures from 6/ 45 cefazolin recipients isolated 12 organisms and from 3/45 latamoxef recipients yielded 5 pathogens, predominantly Escherichia coli and Enterococci. Recent cholecystitis, common bile duct exploration, diabetes mellitus and the type of antibiotic used were not predictive of positive bile cultures. Age > 65 years was the only independent predictive factor (p < 0.001 ). Postoperative wound infections occurred in 2 cefazolin recipients and in 1 latamoxef recipient; the organisms recovered from the wound cultures were different to those recovered in the bile cultures.

The authors concluded that a single dose of either cefazolin or latamoxef was equally effective prophylactically and both were well tolerated. Cefazolin, with its lower cost and narrower antimicrobial spectrum making microbial resistance less likely, is favoured as the standard antibiotic prophylaxis 1n elective biliary surgery. Kellum JM, Duma RJ, Gorbach SL. Sugerman HJ. Haynes Jr BW. el al Arch1ves of Surgery 122 918-922, Aug 1987

12 INPHARMA® 19 December 1987 0156-2703/87/1219-0012/0$01.00/0 © ADIS Press