Cefotetan and cefoxitin, commonly used to treat endometritis, are broad-spectrum antibiotics active against both aerobic and anaerobic gram-positive and gram-negative organisms. MacGregor and colleagues conducted a double-blind, randomized clinical trial to compare the efficacy of the two drugs.
The study included a total of 140 women with endometritis after cesarean section; 11 were not evaluable. The women included in the study presented with uterine tenderness and a temperature of 38.3 [degrees] C (101 [degrees] F) or higher 12 hours postoperatively. The women were assigned to treatment with either cefotetan, 2g intravenously every 12 hours, alternating with placebo every 12 hours, or cefoxitin, 2g intravenously every six hours.
A cure, defined as a decrease in temperature and uterine tenderness within the first 48 hours of therapy, was achieved in 55 (83 percent) of the 66 women who received cefotetan and 50 (79 percent) of the 63 women who received cefoxitin. Clinical adverse effects included diarrhea, nausea and vomiting, pruritus, vaginal candidiasis and headache, and were generally mild and self-limiting. Wound infections developed in two patients treated with cefoxitin and in one patient treated with cefotetan. During a follow-up period that lasted four to six weeks, one patient in each group had a relapse. Use of cefotetan saved an average of $75 per treatment course.
The data indicate that cefotetan and cefoxitin are equally safe and effective. The authors recommend the use of cefotetan based on lower cost and the advantage of twice-daily dosing. (American Journal of Obstetrics and Gynecology, July 1992, vol. 167, p. 139.)
COPYRIGHT 1993 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group
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