Abstract

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.