Prophylactic cephalothin in gastrointestinal surgery.

A prospective study was carried out to evaluate the effect of a strictly standardized, short-term prophylactic treatment with cephalothin (Keflin) on the incidence of postoperative wound infections in gastrointestinal surgery. Achieved levels of cephalothin activity in serum and interstitial water were studied, and the sensitivity of isolated bacteria at the end of operation and from septic wounds was defined. Patients were divided at random into treatment and control groups. The treatment group received 2 g cephalothin at the induction of anesthesia and another 2 g, 5 and 10 hours after the primary infusion. The control group remained untreated. The rapid infusion of 2 g cephalothin resulted in high initial serum levels, which declined rapidly. Equilibration between intraand extravascular compartments occurred about 60-80 minutes after start of infusion. At that time the infused dose resulted in a cephalothin level of about 30 mug/ml in ECV and plasma, or about 30% of the initial concentration. Despite the prophylactic infusion of cephalothin, the frequency of wound infection in treated patients was the same as in the controls. Subdivision of the material according to type of surgery performed did not reveal any difference between untreated patients and controls. No shift towards cephalothin-resistant strains was observed in isolates from septic wounds in the treatment group.

RCT Entities:   Population Interventions Outcomes