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. 1995;3(1):28–33. doi: 10.1155/S1064744995000263

Single-Blind, Prospective, Randomized Study of Cefmetazole and Cefoxitin in the Treatment of Postcesarean Endometritis

Ashwin Chatwani 1,✉, Mark Martens 2, David A Grimes 3, Molly Chatterjee 4, Melvin Noah 5, Marion M Stamp-Cole 5, Kimberly T Perry 5, the Cefmetazole Study Group
PMCID: PMC2364413  PMID: 18475417

Abstract

Objective: The purpose of this study was to compare the clinical efficacy and safety of cefmetazole given by IV push with that of parenterally administered cefoxitin for the treatment of endometritis following cesarean delivery.

Methods: In a single-blind, multicenter, prospective, randomized study, 355 patients with endometritis after cesarean delivery were enrolled and received medication. Administered was either cefmetazole sodium, 2 g by IV push over 1 min q 8 h, or cefoxitin sodium, 2 g IV q 6 h in a 2:1 ratio. The patients were followed for clinical responses and side effects.

Results: The cure rate for cefmetazole was 89% and for cefoxitin it was 79% (P = 0.006). The adverse events were similar in both groups.

Conclusions: Cefmetazole was significantly more effective than cefoxitin in the treatment of endometritis following cesarean delivery.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barza M., Brusch J., Bergeron M. G., Weinstein L. Penetration of antibiotics into fibrin loci in vivo. 3. Intermittent vs. continuous infusion and the effect of probenecid. J Infect Dis. 1974 Jan;129(1):73–78. doi: 10.1093/infdis/129.1.73. [DOI] [PubMed] [Google Scholar]
  2. Berne T. V., Yellin A. E., Appleman M. D., Gill M. A., Chenella F. C., Heseltine P. N. Controlled comparison of cefmetazole with cefoxitin for prophylaxis in elective cholecystectomy. Surg Gynecol Obstet. 1990 Feb;170(2):137–140. [PubMed] [Google Scholar]
  3. Brook I. Use of cephalosporins for prophylaxis and therapy of polymicrobial infection in mice. Antimicrob Agents Chemother. 1993 Jul;37(7):1531–1535. doi: 10.1128/aac.37.7.1531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. DiPiro J. T., Connors J. E., Bowden T. A., Jr, Stanfield J. A., Lampert B. M., Stewart J. T. Comparative intraoperative concentrations of two cephalosporins with activity against anaerobic bacteria. J Antimicrob Chemother. 1989 Apr;23 (Suppl 500):89–95. doi: 10.1093/jac/23.suppl_d.89. [DOI] [PubMed] [Google Scholar]
  5. Duff P. Pathophysiology and management of postcesarean endomyometritis. Obstet Gynecol. 1986 Feb;67(2):269–276. doi: 10.1097/00006250-198602000-00021. [DOI] [PubMed] [Google Scholar]
  6. Eschenbach D. A., Buchanan T. M., Pollock H. M., Forsyth P. S., Alexander E. R., Lin J. S., Wang S. P., Wentworth B. B., MacCormack W. M., Holmes K. K. Polymicrobial etiology of acute pelvic inflammatory disease. N Engl J Med. 1975 Jul 24;293(4):166–171. doi: 10.1056/NEJM197507242930403. [DOI] [PubMed] [Google Scholar]
  7. Faro S., Sanders C. V., Aldridge K. E. Use of single-agent antimicrobial therapy in the treatment of polymicrobial female pelvic infections. Obstet Gynecol. 1982 Aug;60(2):232–236. [PubMed] [Google Scholar]
  8. Frank E., Phillips S. L., Gupta T., Bavishi N., Casey K. K. Treatment of skin and soft tissue infections: a comparative study of cefmetazole and cefoxitin. J Antimicrob Chemother. 1989 Apr;23 (Suppl 500):55–60. doi: 10.1093/jac/23.suppl_d.55. [DOI] [PubMed] [Google Scholar]
  9. Gorbach S. L., Bartlett J. G. Editorial: Anaerobic infections: old myths and new realities. J Infect Dis. 1974 Sep;130(3):307–310. doi: 10.1093/infdis/130.3.307. [DOI] [PubMed] [Google Scholar]
  10. Hager W. D., McDaniel P. S. Treatment of serious obstetric and gynecologic infections with cefoxitin. J Reprod Med. 1983 May;28(5):337–340. [PubMed] [Google Scholar]
  11. Jones R. N., Barry A. L., Fuchs P. C., Thornsberry C. Antimicrobial activity of cefmetazole (CS-1170) and recommendations for susceptibility testing by disk diffusion, dilution, and anaerobic methods. J Clin Microbiol. 1986 Dec;24(6):1055–1059. doi: 10.1128/jcm.24.6.1055-1059.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Jones R. N. Review of the in-vitro spectrum and characteristics of cefmetazole (CS-1170). J Antimicrob Chemother. 1989 Apr;23 (Suppl 500):1–12. doi: 10.1093/jac/23.suppl_d.1. [DOI] [PubMed] [Google Scholar]
  13. Jones R. N. Role of new cephamycins in the management of obstetric and gynecologic infections. J Reprod Med. 1990 Nov;35(11 Suppl):1070–1077. [PubMed] [Google Scholar]
  14. MacGregor R. R., Graziani A. L., Samuels P. Randomized, double-blind study of cefotetan and cefoxitin in post-cesarean section endometritis. Am J Obstet Gynecol. 1992 Jul;167(1):139–143. doi: 10.1016/s0002-9378(11)91648-2. [DOI] [PubMed] [Google Scholar]
  15. Martinusen S., Chen D., Frighetto L., Bunz D., Stiver H. G., Jewesson P. J. Comparison of cefoxitin and ceftizoxime in a hospital therapeutic interchange program. CMAJ. 1993 Apr 1;148(7):1161–1169. [PMC free article] [PubMed] [Google Scholar]
  16. Roy S., Wilkins J., Galaif E., Azen C. Comparative efficacy and safety of cefmetazole or cefoxitin in the prevention of postoperative infection following vaginal and abdominal hysterectomy. J Antimicrob Chemother. 1989 Apr;23 (Suppl 500):109–117. doi: 10.1093/jac/23.suppl_d.109. [DOI] [PubMed] [Google Scholar]
  17. Shimada J., Hayashi Y., Nakamura K. Cefmetazole: clinical evaluation of efficacy and safety in Japan. Drugs Exp Clin Res. 1985;11(3):181–194. [PubMed] [Google Scholar]
  18. Sweet R. L. Anaerobic infections of the female genital tract. Am J Obstet Gynecol. 1975 Aug 1;122(7):891–901. doi: 10.1016/0002-9378(75)90736-x. [DOI] [PubMed] [Google Scholar]
  19. Sweet R. L., Ledger W. J. Cefoxitin: single-agent treatment of mixed aerobic-anaerobic pelvic infections. Obstet Gynecol. 1979 Aug;54(2):193–198. [PubMed] [Google Scholar]
  20. Wright D. B. Antimicrobial formulary management: a case study in a teaching hospital. Pharmacotherapy. 1991;11(1 ):27S–31S. [PubMed] [Google Scholar]

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