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PubMed1998

Distribution of free and liposomal cefoxitin in plasma and peritoneal fluid in a porcine intra-abdominal sepsis model.

The plasma and peritoneal fluid pharmacokinetic parameters obtained after the intravenous administration of free and liposomal cefoxitin were studied in a porcine model of intraabdominal sepsis. No prior assumptions were made to predict the number of compartments pertaining to drug clearance from the administration of either cefoxitin formulation. The experimental data obtained were applied to fit mathematical models of multiexponential drug clearance and the pharmacokinetic data were found to best fit a two-compartment open model. Liposomal encapsulation significantly altered the plasma drug distribution pattern resulting in changes in the magnitude of a number of pharmacokinetic parameters examined. The mean post-distributive half-life of liposomal cefoxitin was substantially longer than that of free cefoxitin by at least 3 times. The peritoneal cavity appeared to provide a reservoir for the initial distributive phase of rapid drug clearance from the plasma compartment followed by a less-rapid post-distributive phase. The cumulative drug level, as determined by the area under the concentration curve (AUC) as a function of time, in the plasma of animals treated with liposomal cefoxitin was about 3-4 fold as high as that of animals treated with free cefoxitin. The differences in pharmacokinetic parameters appeared to account for the improved therapeutic efficacy of liposomal cefoxitin in this animal model.

Abdomen↗
PubMed1980

Cefoxitin resistance by a chromosomal cephalosporinase in Escherichia coli.

Cefoxitin resistance, an unique property found in clinical isolates of Escherichia coli was investigated. Cefoxitin resistant strains, 255 and GN206, produced cephalosporinase constitutively. The cephalosporinase was located in the periplasm, and its production was considered to be mediated by chromosomal gene(s). Cephalosporinase-less mutants from both strains were susceptible to cefoxitin as well as other beta-lactam antibiotics, suggesting that the cephalosporinase was responsible for the resistance to beta-lactam antibiotics including cefoxitin. The cephalosporinases from the E. coli strains were partially purified and their enzymological properties were compared with those of cephalosporinases of Citrobacter freundii and Proteus morganii. Although the cephalosporinases of E. coli, as well as other cephalosporinases, showed little activity for cefoxitin-hydrolysis, the E. coli cephalosporinases exhibited a significantly higher affinity for cefoxitin than other cephalosporinases. It was assumed that the E. coli enzyme located around the targets of cefoxitin protected the targets from the antibiotic by its high affinity for the antibiotic.

Cefoxitin↗
PubMed1992

Cefoxitin-induced antibiotic resistance in Enterobacter species in the community hospital.

The aim of this study was to determine whether beta-lactamases could be induced by cefoxitin in the community hospital, since this problem of antibiotic resistance has been shown to exist at the tertiary care level. One hundred sixty-six Enterobacter species isolated from patients in two community hospitals in Dayton, Ohio, were tested for cefoxitin induction of beta-lactamase production by a disk-approximation method. Piperacillin and cefoxitin disks were placed in approximation to each other on Mueller-Hinton plates inoculated with Enterobacter species with appropriate controls. Three Enterobacter strains (1.8%) showed truncation of the zone of inhibition (indicating beta-lactamase induction) with sensitivity to both cefoxitin and piperacillin. However, 84 strains (50.6%) showed truncation around the piperacillin disk with resistance to cefoxitin. One hundred fifty (90.0%) strains showed resistance to cefoxitin. These data indicate that cefoxitin induction of beta-lactamases in Enterobacter species is indeed a potential problem in incurring antibiotic resistance in the community hospital.

Cefoxitin↗
PubMed1989

[Cefoxitin in the preventive treatment of infectious complications in high-risk gastro-jejuno-colic and biliary surgery].

Cefoxitin is a bactericidal beta lactam antibiotic of the cephamycins group, with wide antimicrobial efficacy and active against both aerobes and anaerobes. In this study, 58 patients were divided in four groups according to the site of the disease (stomach, gallbladder and biliary tract, jejunum ileum and colon-rectum). The efficacy of cefoxitin in the prophylaxis of surgical infections was assessed for each group and for all patients. When compared with the combination of antibiotics used previously, cefoxitin led to a reduction of the mean duration of fever (7.2 and 5 days respectively with ampicillin/cloxacillin and lincomycin/gentamycin, 3.2 days with cefoxitin). Cefoxitin also led to a reduction in the incidence of surgical infections (50% with ampicillin/cloxacillin, 9.19% with lincomycin/gentamycin, 8.6% with cefoxitin) and in the incidence of localized surgical infections (29.6%, 20.3%, 8.6% respectively). In this study, cefoxitin has been found to be very useful and well tolerated in the prophylaxis of surgical infections.

Adult↗
PubMed1986

[In vitro effect of piperacillin, amoxicillin, cefoxitin and metronidazole against obligate anaerobic bacteria].

The minimum inhibitory concentrations (MIC) of piperacillin and three other antibiotics (amoxicillin, cefoxitin, metronidazole) against 165 strains of obligate anaerobes isolated in hospitals in 1985 and 1986 were determined by the Wilkins-Chalgren agar medium dilution method. Among the 67 strains of Bacteroides fragilis, 98.5% were sensitive to piperacillin (MIC less than or equal to 128 mg/l), 100% were sensitive to metronidazole (MIC less than or equal to 4 mg/l), 11.9% were resistant to cefoxitin (MIC greater than 32 mg/l) and 46% were resistant to amoxicillin (MIC greater than 16 mg/l). The MIC50 was about 4 mg/l with piperacillin, 8 mg/l with cefoxitin and 0.5 mg/l with metronidazole. All 32 strains of Clostridium perfringens were sensitive to the 4 antibiotics tested, with an MIC50 of about 0.06 mg/l with piperacillin, 0.125 mg/l with amoxicillin and 0.5 mg/l with cefoxitin and metronidazole. All other strains of Clostridium spp. (33 in all) were sensitive to piperacillin and metronidazole; the MIC's were about 0.06 mg/l with piperacillin, 0.25 mg/l with amoxicillin and metronidazole and 0.5 mg/l with cefoxitin. Seven strains (C. innocuum 5, C. difficile 1, C. ramosum 1) were resistant to cefoxitin. All 33 strains of Peptostreptococcus and Peptococcus were sensitive to the 4 antibiotics tested. Although metronidazole still is the most effective of anti-anaerobes agents, piperacillin has proved to be effective against most anaerobic bacteria, including B. fragilis. It is clearly superior to amoxicillin and relatively superior to cefoxitin, notably against this species.

Amoxicillin↗
PubMed1986

Comparison of single-dose moxalactam and a three-dose regimen of cefoxitin for prophylaxis in vaginal hysterectomy.

In patients undergoing vaginal hysterectomy, prophylactic use of a single dose of moxalactam was compared with use of a standard three-dose regimen of cefoxitin for efficacy and for rate of postoperative colonization of the vaginal cuff with resistant bacteria. In a prospective, randomized study, patients hospitalized for vaginal hysterectomy received either cefoxitin sodium 2 g intramuscularly on call to the operating room followed by 2 g intravenously every six hours for two additional doses or a single dose of moxalactam disodium 2 g intramuscularly on call. Cultures of the meatal area and of urine were obtained preoperatively; postoperatively, cultures of urine, of the vaginal cuff, and of any site or fluid presumed to be infected were obtained. Data were evaluated for 38 patients in the moxalactam group and 40 patients in the cefoxitin group. There was no significant difference in the incidence of infectious morbidity (7.5% of cefoxitin-treated patients and 10.5% of moxalactam-treated patients). Infectious morbidity was not related to age, length of surgery, or estimated blood loss. The incidence of febrile morbidity was not significantly different (7.5% of the cefoxitin group and 13.2% of the moxalactam group). Colonization of the vaginal cuff with resistant organisms occurred in 70% of cefoxitin patients and 71% of moxalactam patients and was a poor predictor of infectious morbidity. In these 78 women undergoing vaginal hysterectomy, single-dose moxalactam and a three-dose regimen of cefoxitin were equally effective for surgical prophylaxis.

Adult↗
PubMed1984

Effect of dialysis on interference by cefoxitin with determination of creatinine.

Interference by cefoxitin with determination of creatinine is less with the Technicon SMAC than with other commercial analytical systems. The SMAC assay involves a single-point kinetic method with dialysis, whereas most other commercial methods are multipoint kinetic without dialysis. The apparent creatinine concentration measured for aqueous solutions of cefoxitin was 73 mmol of creatinine per mole of cefoxitin with the SMAC, 135 mmol/mol with a manual method. Furthermore, we determined for the SMAC that the average fraction of creatinine dialyzed was 0.128 and for cefoxitin, 0.064. Thus, the concentration of and interference by cefoxitin in the reaction mixture for SMAC are reduced by half (i.e., the apparent creatinine concentration for cefoxitin with the manual system multiplied by 0.5 is essentially that noted with the SMAC: 68 vs 73). Thus we conclude that the diminished interference be cefoxitin with determination of creatinine by SMAC is primarily ascribable to the dialysis step.

Autoanalysis↗
PubMed1982

Use of clinical pharmacists to reduce cefamandole, cefoxitin, and ticarcillin costs.

The financial impact of using cefamandole and cefoxitin rather than cefazolin and of using ticarcillin rather than carbenicillin in one institution was assessed; the effectiveness of clinical pharmacists in reducing the costs associated with these drugs also was determined. During Phase 1 (July 1, 1980-March 31, 1981), the numbers of intravenous piggyback cefazolin, cephalothin, cefamandole, cefoxitin, carbenicillin, and ticarcillin doses prepared were recorded. Quarterly purchase data for each drug were determined from invoice records. During Phase 2 (April 1, 1981-September 30, 1981), eight clinical pharmacists reviewed all patient charts for cefamandole, cefoxitin, and ticarcillin orders. If the indication for these orders was missing or considered inappropriate, the pharmacist contacted the prescriber and recommended substituting appropriate doses of cefazolin for cefamandole and cefoxitin and of carbenicillin for ticarcillin. The number of doses prepared and quarterly purchase data were collected as in Phase 1. The projected savings resulting from clinical pharmacist input relating to these drugs was calculated. Based on Phase 1 data, the total theoretical expense resulting from cefamandole and cefoxitin use instead of cefazolin and from ticarcillin use in place of carbenicillin was projected to be $233,448 annually. Cefamandole and cefoxitin accounted for 59.8 and 39.7% of total cephalosporin use in Phases 1 and 2, respectively. Ticarcillin accounted for 77.1% of the total ticarcillin and carbenicillin doses in Phase 1, and 16.6% in Phase 2. A projected annual savings of $156,756 was achieved because of clinical pharmacist input at a cost of $16,000 for time devoted to the effort. Clinical pharmacists were effective in reducing the use of cefamandole, cefoxitin, and ticarcillin in situations where cefazolin or carbenicillin could be substituted.

Anti-Bacterial Agents↗
PubMed1981

[Some experiences in the field of pediatrics with cefoxitin treatment by intravenous injections (author's transl)].

Following are the results obtained from studies made with cefoxitin in the field of pediatrics: (1) The peak serum level observed upon completion of the one hour drip infusion in a dose of 20-25 mg/kg of cefoxitin varied from 66.4 to 93.0 mcg/ml. This fell to a remarkably low level after 2 hours. The serum half-life varied from 18.84 to 27.86 minutes. (2) The cumulative quantity of cefoxitin excreted in the active form in the urine by the end of 6 hours after completion of the drip infusion was 92.9-93.8%. (3) All of the 42 patients with acute pediatric infection (such as various kinds of acute upper or lower respiratory tract infection, urinary tract infection were treated with either cefoxitin by a single shot (23 patients), or by drip infusion (19 patients). The dosage employed was approximately 50-100 mg/kg/day divided into two to three treatments. There was no major difference in the clinical efficacy between administering two times or three times, the efficacy rates being 96% and 89% respectively. The overall efficacy rate was 93%. (4) In either case of intravenous injections by either a single shot or drip infusion, excellent clinical responses were obtained in most patients. These people had a variety of infections, which were considered to be caused by various kinds of Gram-positive cocci, E. coli (including ABPC resistance), P. mirabilis, Kl. oxytoca and Haemophilus. (5) Out of the 42 patients who received cefoxitin in a daily dose of 5-100 mg/kg divided into two or three times either by a single shot or drip infusion, no hepatic or renal function abnormality was observed except for 2 cases of temporary eosinophilia. (6) On the basis of these results, cefoxitin was found to be a highly useful antibiotic in the treatment of acute pediatric infection caused by microorganisms which are sensitive to cefoxitin.

Age Factors↗
PubMed1981

[Laboratory and clinical studies of cefoxitin in pediatric field (author's transl)].

The authors have carried out the laboratory and clinical studies of cefoxitin. The results were as follows: The sensitivity was estimated by plate dilution method on 26 strains of S. aureus, 25 strains of E. coli, 24 strains of K. pneumoniae, 27 strains of Serratia and 17 strains of Salmonella isolated from patients. The distribution of sensitivity of S. aureus was 1.56-3.13 microgram/ml and the peak of distribution was 3.13 microgram/ml. The strains of 76.0% of E. coli was inhibited at concentration of less than 3.13 microgram/ml. The strains of 91.7% of K. pneumoniae was inhibited at concentration of less than 3.13 microgram/ml. The distribution of sensitivity of Serratia was 6.25-more than 100 microgram/ml and the peak of distribution was 100 microgram/ml. The all strains of Salmonella were inhibited at concentration of less than 3.13 microgram/ml. Cefoxitin was given by intravenous administration for 5 minutes at a single dose of 25 mg/kg of cefoxitin to 2 children, and by drip infusion for 60 minutes at a single dose of 25 mg/kg of cefoxitin to 4 children. After intravenous administration of cefoxitin, the mean peak of serum level was 67.3 +/- 6.3 microgram/ml at 15 minutes, and at 4 and 6 hours after administration was not detected. Half-life time was 22 minutes. And after drip infusion of cefoxitin for 60 minutes, the mean peak of serum level was 35.7 +/- 5.3 microgram/ml at 1 hour, and at 4 and 6 hours after administration was not detected. Half-life time was 20 minutes. The mean urinary recovery rate was 82.4 +/- 3.0% and 90.2 +/- 6.8% up to 6 hours after intravenous administration and drip infusion respectively. Cefoxitin was effective in all of 15 cases with bacterial infections. No side effects was observed.

Adolescent↗
PubMed1981

[Clinical studies of cefoxitin in the pediatric field (author's transl)].

1. The in vitro antibacterial activity of cefoxitin was nearly equal to that of CEZ and CET against the 6 species of clinically isolated strains. Cefoxitin, furthermore, had an antibacterial activity against the strains of P. morganii resistant to CEZ and CET. 2. Cefoxitin was applied to a total of 17 patients including 6 cases of bronchitis, 5 of pneumonia, 2 of enteritis, and 1 each of pharyngitis, laryngitis, sinusitis and lymphadenitis. The results showed an efficacy rate of 88%. In the 6 patients from whom the isolation of pathogenic organisms was possible, the bacteriological response to cefoxitin was appreciable the efficacy rate being 83%. Thus, it is considered that cefoxitin also has a significant antibacterial activity in vivo. 3. As to the side effects following the administration of cefoxitin, urticaria-like eruption was observed in 1 case, and an elevation of transaminase in another. These findings, however, became normal soon after discontinuation of cefoxitin treatment.

Adolescent↗
PubMedDate not supplied

Comparison of the pharmacodynamic activity of cefotaxime plus metronidazole with cefoxitin and ampicillin plus sulbactam.

STUDY OBJECTIVE: To compare the pharmacokinetic and pharmacodynamic activity of three drug regimens: cefotaxime plus metronidazole, cefoxitin, and ampicillin-sulbactam against two organisms frequently isolated in intraabdominal infection, Escherichia coli and Bacteroides fragilis. DESIGN: Open-label, three-way crossover study. SETTING: Hartford Hospital Clinical Research Center. PARTICIPANTS: Nine healthy volunteers. INTERVENTIONS: Subjects received the following regimens: (1) a single 1-g intravenous dose of cefotaxime plus a single 500-mg oral dose of metronidazole; (2) two intravenous doses of cefoxitin, 2 g each dose given every 6 hours; and (3) two intravenous doses of ampicillin-sulbactam, 3 g each dose given every 6 hours. MEASUREMENTS AND MAIN RESULTS: Serum bactericidal titers and drug concentrations were measured over a 12-hour period. The cefotaxime-metronidazole regimen showed superior activity against E. coli compared with ampicillin-sulbactam and cefoxitin. The mean areas under the bactericidal activity curve (AUBC) for the three regimens were 550.2, 68.7, and 48.9, respectively (p = 0.0001). There was no significant difference in AUBC among the three regimens for B. fragilis. Serum concentrations of cefotaxime remained above the minimum inhibitory concentration (MIC) for E. coli significantly longer than did concentrations of ampicillin-sulbactam and cefoxitin (p = 0.0002 and p = 0.0023, respectively). Serum concentrations of metronidazole were still at 9 times the MIC for B. fragilis at the end of the 12-hour dosing interval; for ampicillin-sulbactam and cefoxitin concentrations remained above the MIC for one-half and less than one-fourth, respectively, of the dosing interval (p < 0.0001). The ratio of AUC:MIC was also favorable for metronidazole (212.2) compared with 63.4 for ampicillin-sulbactam and 9.2 for cefoxitin. CONCLUSIONS: The combination of cefotaxime-metronidazole, even at the relatively low doses used in this study, provides coverage against gram-negative and anaerobic pathogens that is at least as effective as that of cefoxitin and ampicillin-sulbactam. In addition, its cost is considerably less expensive than that of the other regimens.

Administration, Oral↗
PubMed1993

In vitro antibacterial activity of cefoxitin and cefotetan and pharmacokinetics in dogs.

The susceptibility of 50 clinical Escherichia coli isolates to various antibacterials, including cefoxitin and cefotetan was ascertained, and the minimal inhibitory concentration (MIC) of cefoxitin and cefotetan for each of these isolates was determined. The pharmacokinetics of cefoxitin and cefotetan after a single i.v. or SC injection (30 mg/kg of body weight) were determined in 4 dogs. Of the 50 E coli isolates, 98% were susceptible in vitro to cefotetan, 90% were susceptible to cefoxitin, and 88% were susceptible to gentamicin. The MIC that would inhibit the growth of 90% of the E coli isolates (MIC90) was 0.25 microgram/ml for cefotetan and 4 micrograms/ml for cefoxitin. Plasma cefotetan concentrations remained above MIC90 for (mean +/- SD) 8.2 +/- 1.72 hours and 13.52 +/- 0.28 hours after i.v. and SC administration, respectively. Plasma cefoxitin concentrations remained above MIC90 for (mean +/- SD) 5.37 +/- 1.18 hours and 7.95 +/- 0.71 hours after i.v. and SC administration, respectively. We concluded that cefotetan was superior to cefoxitin in activity against E coli in vitro. We recommend that cefotetan be given at a dosage of 30 mg/kg, i.v., every 8 hours, or SC, every 12 hours.

Animals↗
PubMed1974

Cefoxitin, a semisynthetic cephamycin antibiotic: resistance to beta-lactamase inactivation.

Cefoxitin is a new, cephalosporin-like antibiotic which is highly resistant to hydrolysis by beta-lactamase. Ninety-one cultures were selected either for their general resistance to cephalosporin antibiotics or for their ability to produce beta-lactamase. Some of these cultures were resistant to cefoxitin. The capacity of each of the 91 strains to hydrolyze cefoxitin with beta-lactamase was determined. Only seven of the cultures degraded the antibiotic as determined by a general assay for beta-lactamase. Several others were able to hydrolyze cefoxitin after enzyme was induced by low concentrations of the antibiotic. The role of the constitutive and inducible enzyme in bacterial resistance to the antibiotic was investigated. Enzymatic destruction of cefoxitin was found to be an important factor contributing to bacterial resistance. However, the complete and rapid degradation of cefoxitin is not essential to resistance since one strain, Enterobacter cloacae 1316, hydrolyzed the antibiotic very slowly but was able to grow unaffected in the presence of cefoxitin. The presence of the enzyme is not necessarily sufficient to confer resistance since another culture, Klebsiella D535, readily hydrolyzed the antibiotic but was susceptible to it.

Carbamates↗
PubMed1988

Serum and tissue concentrations of cefoxitin and cefotaxime in women undergoing hysterectomy.

In a comparative study of serum and uterine tissue concentrations of cefoxitin and cefotaxime in patients undergoing hysterectomy, 40 patients were randomised to receive either cefoxitin 2g or cefotaxime 2g by intravenous administration. Serum samples were obtained before drug administration, at the ligation of the uterine arteries and at the end of surgery. Cefoxitin, cefotaxime and desacetylcefotaxime concentrations were determined by high performance liquid chromatography. The composite serum half-lives (determined by linear regression) for cefoxitin, cefotaxime and desacetylcefotaxime were 0.8, 0.7 and 2.1 hours, respectively. Although serum concentrations were higher for cefotaxime than for cefoxitin after a 2g dose, the uterine concentrations (at 40 mins) of cefoxitin were higher (51 micrograms/g vs 16 micrograms/g) than those of cefotaxime. After a 2g dose of cefotaxime the desacetylcefotaxime peak uterine concentration was 8 micrograms/g. Both drugs achieved adequate concentrations in serum and uterine tissue to prevent and treat infections caused by common Enterobacteriaceae such as Escherichia coli, with cefotaxime having a longer apparent duration of activity. However, cefoxitin provided serum and uterine concentrations above the minimum inhibitory concentration of Bacteroides fragilis for a longer period than did cefotaxime.

Adult↗
PubMed1976

Comparative clinical pharmacology of intravenous cefoxitin and cephalothin.

Intravenous doses of 0.5, 1, and 2 g cephalothin and cefoxitin, a semi-synthetic cephamycin antibiotic highly resistant to bacterial cephalosporinase, were infused over a period of 3 minutes into 18 normal adult males by a randomized, crossover design. Serum and urine data on cefoxitin best fit a two-compartment open model. Serum concentrations following cefoxitin were higher and more prolonged and urine recoveries higher than those following equal doses of cephalothin. The terminal serum half-life of cefoxitin was longer at all dose levels. Renal clearance of cephalothin-like activity exceeded that of cefoxitin, which may possess dose-dependent kinetics. Whereas cephalothin has been reported to metabolize by greater than 35% to the less active desacetyl form, cefoxitin was metabolized by 0.1 to 6% to the descarbamyl form in individual subjects.

Adult↗
PubMed1977

[In vitro susceptibility of bacteroidaceae to cefoxitin and cephalothin (author's transl)].

The activity of the new cephamycin C derivatives cefoxitin against 102 clinical isolates of Bacteroidaceae (95 Bacteroides strains and 7 Fusobacterium-Sphaerophorus cultures) was determined by tube dilution and standardized agar diffusion tests and compared to that of cephalothin. Cefoxitin was more active than cephalothin against 56 Bacteroides fragilis strains, 19 Bacteroides thetaiota-omicron strains and two Bacteroides splanchnicus strains. The difference seemed less pronounced with five Bacteroides vulgatus and four Bacteroides variabilis cultures. Three Bacteroides melaninogenicus and six Bacteroides oralis strains displayed similar sensitivity to both cephalosporins. At concentrations of 32 microng/ml or less, cefoxitin inhibited 91% and cephalothin 33% of the Bacteroides strains. Two strains of Sphaerophorus varius were likewise much more sensitive to cefoxitin than to cephalothin (MIC values 8 micron8/ml of cefoxitin and 256 microng/ml of cephalothin). Three other Sphaerophorus strains (the species necrophorus and freundii/mortiferum) and two of Fusobacterium fusiforme (Fusobacterium nucleatum) strains were very similar in their susceptibility to both cephalosporins. Statistical analysis of the relationship between MIC and zone size diameter showed relatively high correlation coefficients for cefoxitin and cephalothin (r=-0.741 and r=-0.703 respectively).

Bacteroidaceae↗
PubMedDate not supplied

Infectious complications after 809 biliary tract operations and results of a prospective randomized single-blind study comparing cefoxitin versus ampicillin plus an inhibitor of beta-lactamases.

A retrospective analysis of 809 biliary tract operations revealed postoperative wound infections in 13.4% of 278 patients with bactericholia, compared to 6.9% in patients without bactericholia. More than one third of isolated bacteria were resistant to ampicillin. This was the basis to conduct a prospective randomized single-blind study to compare the efficacy of ampicillin in combination with the beta-lactamase-inhibitor sulbactam with cefoxitin as perioperative prophylaxis in elective biliary surgery. Patients received a single dose of either 2 g ampicillin plus 1 g sulbactam or 2 g cefoxitin as intravenous short-infusion approximately 30 min prior to skin incision. Both groups were comparable concerning demographic and nosographic data. 80 of 83 patients were evaluable for efficacy; 39 received ampicillin/sulbactam and 41 cefoxitin. In the cefoxitin group two wound infections were observed. In the ampicillin/sulbactam group one patient developed postoperative temperatures of greater than 39.0 degrees C, which was regarded as a wound-related infectious complication. In addition, there occurred five urinary tract infections (cefoxitin: 3; ampicillin/sulbactam: 2) but no pulmonary infection. In conclusion, no significant difference between the two groups could be shown. Both regimens were well tolerated with no significant differences between treatment groups. The combination of ampicillin with the beta-lactamase-inhibitor sulbactam can be regarded as safe and as effective compared to cefoxitin for single-dose prophylaxis of post-operative infections after biliary tract operations.

Adult↗