In a randomized, single-blind study, the efficacy of single-dose cefotaxime was compared with multiple dose cefoxitin in genitourinary surgery prophylaxis. Patients received either 1.0 g cefotaxime before surgery; or 2.0 g cefoxitin pre-operatively and every 8 h for no more than 24 h post-operatively. Of the evaluable patients receiving cefotaxime 3 of 35 (8.6%) became infected post-operatively, compared to 12 of 37 (32.4%) patients receiving cefoxitin (P less than 0.01). It is concluded that single-dose genitourinary surgical prophylaxis with cefotaxime may be more effective than a longer dosing schedule with cefoxitin in the prevention of post-operative urinary tract infections, and that a single-dose regimen may represent significant cost containment advantages for hospitals.
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