Article Text

A prospective randomized trial of ampicillin/sulbactam vs cefoxitin prophylaxis for radical gynecologic surgery
  1. J. Fanning,
  2. D. J. Sweetland and
  3. R. D. Hilgers
  1. Division of Gynecologic Oncology, Medical College of Ohio, Toledo, USA
  1. Address for correspondence: Dr J. Fanning, Division of Gynecologic Oncology, Medical College of Ohio, Toledo, OH 43699-0008, USA.


The objective of this study was to compare the effectiveness of ampicillin/sulbactam vs cefoxitin for the prevention of postoperative febrile morbidity and operative site infection in patients undergoing radical surgery for gynecological malignancies and to evaluate the occurrence ofClostridium difficile toxin-associated colitis in patients receiving these prophylactic antibiotics. A prospective randomized trial of 150 patients, 75 receiving ampicillin/sulbactam and 75 receiving cefoxitin. No significant differences in patient characteristics, preoperative risk factors or surgical characteristics were detected between the two groups. Twenty-one of 75 patients (28%) receiving ampicillin/sulbactam developed febrile morbidity compared with 31 of 75 patients (41%) receiving cefoxitin. Surgical site infection (3% vs 5%) and nonsurgical site infections (13% vs 12%) were comparable. Four patients (5%) treated with cefoxitin developed C.difficile toxin-associated colitis vs no patients treated with ampicillin/sulbactam. Ampicillin/sulbactam prophylaxis is comparable to cefoxitin in prevention of surgical site infection but is not associated with C. difficile toxin-associated colitis.

  • antibiotic
  • colitis
  • surgical prophylaxis

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