RESUMO
Five hundred and sixty-six women, consecutively admitted to nine different hospitals for elective abdominal hysterectomy, were randomized to receive a single 2 g i.v. dose of either cefotetan or piperacillin at induction of anesthesia. Five patients were excluded and 561 (287 given cefotetan and 274 given piperacillin) could be evaluated. In 10 patients (5 for each drug) the concentrations of either cefotetan or piperacillin in serum and subcutaneous tissue at the beginning and at the end of surgery and in uterus, salpinx and ovary samples, were microbiologically assessed. No significant differences could be found between cefotetan and piperacillin groups for any of the considered infectious complications (bacteremia, wound or vaginal cuff infection, pelvic cellulitis and febrile morbidity) nor for the pooled data (cefotetan group: 4.9%, piperacillin group: 5.8%, p:NS). As for the concentrations of prophylactic drugs, serum levels throughout surgery were found to be adequate.
Assuntos
Cefotetan/uso terapêutico , Histerectomia/métodos , Piperacilina/uso terapêutico , Pré-Medicação , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Infecção da Ferida Cirúrgica/prevenção & controleAssuntos
Antibioticoprofilaxia , Cesárea/efeitos adversos , Piperacilina/uso terapêutico , Infecção da Ferida Cirúrgica/prevenção & controle , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Ensaios Clínicos como Assunto , Esquema de Medicação , Feminino , Humanos , Piperacilina/administração & dosagem , Complicações Pós-Operatórias/prevenção & controle , GravidezRESUMO
The efficacy of two randomized antibiotic prophylactic schedules with ceftazidime (group A: single preoperative 2 g intramuscular dose; group B: 3 perioperative 1 g intramuscular doses every 6 h) was evaluated in 200 pregnant women undergoing cesarean section. Postoperative complications were observed in 9 cases (4 in group A and 5 in group B; p = NS). Analysis of possible risk factors revealed 1) a relationship between postoperative morbidity and overweight (body mass index above 30) in group A only; 2) a possible contributory effect of duration of labor (more than 6 h) in group A; and 3) a possible effect of duration of rupture of the membranes (more than 6 h) in group B only. The results obtained lead to the conclusion that single-dose prophylaxis with ceftazidime is as effective as short-term 3-dose ceftazidime prophylaxis in preventing post-cesarean complications.
