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J R Soc Med. 1986 March; 79(3): 137–141.
PMCID: PMC1290230

Single-dose antibiotic prophylaxis of abdominal surgical wound infection: a trial of preoperative latamoxef against peroperative tetracycline lavage.


A randomized controlled clinical trial was undertaken in 542 consecutive emergency and elective abdominal operations, with one group of patients receiving tetracycline peritoneal and wound lavage and the other a single intravenous injection of 1 g latamoxef at induction of anaesthesia. Seventy-five patients were withdrawn because no potentially contaminated hollow viscus was opened, and a further 36 because they could not be assessed for wound infection. Of the remaining 431 patients, 212 received latamoxef resulting in 5 major and 8 minor wound infections in hospital; another 4 minor infections occurred at home (total incidence 8.0%). In the tetracycline group (n = 219) there were 7 major and 19 minor wound infections in hospital and 10 minor infections later (total incidence 16.4%). This is significantly higher than the rate with latamoxef (P = 0.012). Monitoring of operative and postoperative bleeding revealed no evidence (except in one doubtful case) of excessive bleeding associated with the use of a single dose of latamoxef. It is concluded that single-dose preoperative latamoxef is more effective than peroperative tetracycline lavage for the prevention of wound infections after potentially contaminated abdominal operations.

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Selected References

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  • Ausobsky JR, Pickford IR, Evans M, Pollock AV. Latamoxef for the prophylaxis of abdominal surgical wound infection: a controlled clinical trial. J Hosp Infect. 1983 Sep;4(3):279–284. [PubMed]
  • Krukowski ZH, Matheson NA. The management of peritoneal and parietal contamination in abdominal surgery. Br J Surg. 1983 Jul;70(7):440–441. [PubMed]
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  • Weitekamp MR, Aber RC. Prolonged bleeding times and bleeding diathesis associated with moxalactam administration. JAMA. 1983 Jan 7;249(1):69–71. [PubMed]
  • Morris DL, Fabricius PJ, Ambrose NS, Scammell B, Burdon DW, Keighley MR. A high incidence of bleeding is observed in a trial to determine whether addition of metronidazole is needed with latamoxef for prophylaxis in colorectal surgery. J Hosp Infect. 1984 Dec;5(4):398–408. [PubMed]
  • Pollock AV, Froome K, Evans M. The bacteriology of primary wound sepsis in potentially contaminated abdominal operations: the effect of irrigation, povidone-iodine and cephaloridine on the sepsis rate assessed in a clinical trial. Br J Surg. 1978 Feb;65(2):76–80. [PubMed]
  • Lord JW, Rossi G, Daliana M. Intraoperative antibiotic wound lavage: an attempt to eliminate postoperative infection in arterial and clean general surgical procedures. Ann Surg. 1977 Jun;185(6):634–641. [PubMed]
  • Phillips RK, Dudley HA. The effect of tetracycline lavage and trauma on visceral and parietal peritoneal ultrastructure and adhesion formation. Br J Surg. 1984 Jul;71(7):537–539. [PubMed]
  • Nyström PO, Skau T. Elimination patterns of Escherichia coli and bacteroides fragilis from the peritoneal cavity. Studies with experimental peritonitis in pigs. Acta Chir Scand. 1983;149(4):383–388. [PubMed]

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