A single preoperative dose of cefazolin versus postoperative amoxicillin and gentamycin combination in prophylaxis of orthopaedic and traumatologic surgery.

The use of antibiotic prophylaxis was evaluated in 228 surgical patients. The patients were given either cefazolin preoperatively or amoxicillin + gentamycin postoperatively in a randomized fashion to determine whether cefazolin would demonstrate an advantage over amoxicillin + gentamycin with respect to protection against postoperative wound infection, systemic infection and cost. We also tried to find out if the inflation of a tourniquet would interfere in the incidence of wound infection. Major postoperative wound infections were reduced in the cefazolin treated group (2.56 per cent versus 4.50 per cent). There also was a reduction in minor postoperative wound infections in the cefazolin group when it was compared with the amoxicillin + gentamycin group (6.83 per cent, 13.51 per cent, respectively). No systemic infection was seen in either group. There was no difference between the patients on whom were used tourniquets or not. Analysis of patients' charges suggested that 68.75% of the cost of preoperative antibiotic prophylaxis might be saved by limiting the duration of prophylactic drug administration by cefazolin.

RCT Entities:   Population Interventions Outcomes