Results of a multicenter comparative study of single-dose cefotetan and multiple-dose cefoxitin as prophylaxis in patients undergoing cesarean section.

A study to compare the prophylactic efficacy of a single 2 g dose of cefotetan with multiple 2 g doses of cefoxitin in reducing the incidence of postcesarean section infection was evaluated in a multicenter trial of 269 women. No significant differences in clinical or bacteriologic response were detected between the two groups. A successful clinical response rate was achieved in 139 of 162 of the evaluable subjects given cefotetan (86 percent) and in 71 of 79 patients (90 percent) given cefoxitin. The respective satisfactory bacteriologic response rates were 91 percent (135 of 148 patients) and 93 percent (68 of 73 patients). The incidences of endometritis for cefotetan and cefoxitin (12 percent and 5 percent, respectively) and of postoperative wound infection (3 percent and 5 percent, respectively) were also not significantly different. Bactericidal levels of cefotetan were maintained in plasma in the immediate postpartum period. Both drugs were well tolerated. Single-dose prophylaxis with cefotetan was comparable to multiple doses of cefoxitin in reducing infectious morbidity in women undergoing cesarean section.