A prospective randomized study of moxalactam versus gentamicin and clindamycin in penetrating abdominal trauma

D. J. Kreis, D. Augenstein, O. Martinez, M. Echenique, G. Plasencia, J. J. Vopal, P. Byers, G. A. Gomez

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

We conducted a randomized, prospective study of moxalactam versus gentamicin plus clindamycin in 42 patients with penetrating abdominal trauma. Patients were randomized to receive intravenously either 2 grams of moxalactam every 12 hours or 80 milligrams of gentamicin every eight hours and 600 milligrams of clindamycin every six hours. Antibiotics were administered preoperatively and continued for a minimum of five days if hollow viscus injury occurred. For those without hollow viscus injury, only those patients receiving a minimum of three days of antibiotics were evaluated. A single intramuscular dose of 10 milligrams of vitamin K was also administered to all patients in the moxalactam group. There were 39 males and three females with a mean age of 33 years. Twenty patients received moxalactam and 22 received gentamicin plus clindamycin. The mechanism of injury was gunshot wound in 32 patients and stab wounds in ten patients. Eight patients in each group sustained injuries to the small intestine or colon, or both. The mean injury severity score was 22.6 and 21.1 in the single and double antibiotic regimen, respectively. The mean duration of antibiotic therapy was 5.8 and 7.0 days in the single and double antibiotic group, respectively. No infectious complications occurred in the moxalactam group whereas five infections occurred in four patients in the gentamicin plus clindamycin group (p <0.05). These infections included one intra-abdominal abscess, two wound infections and two episodes of necrotizing fasciitis of the wound and abdominal wall. There were no complications attributable to moxalactam therapy. The over-all mortality rate was zero per cent. The total pharmacy cost of a five day course of moxalactam plus a single dose of vitamin K is $204.67 compared with $226.00 for a similar course of gentamicin plus clindamycin. We conclude that: 1, moxalactam is at least, if not more, effective in preventing infectious complications after penetrating abdominal trauma compared with gentamicin plus clindamycin; 2, moxalactam is safe in the doses used when combined with vitamin K, and 3, moxalactam is more cost-effective than gentamicin plus clindamycin dual antibiotic therapy.

Original languageEnglish (US)
Pages (from-to)1-4
Number of pages4
JournalSurgery Gynecology and Obstetrics
Volume163
Issue number1
StatePublished - 1986
Externally publishedYes

Fingerprint

Moxalactam
Clindamycin
Gentamicins
Prospective Studies
Wounds and Injuries
Anti-Bacterial Agents
Viscera
Vitamin K
Abdominal Abscess
Stab Wounds
Necrotizing Fasciitis
Vitamin K 3
Costs and Cost Analysis
Gunshot Wounds
Injury Severity Score
Abdominal Wall
Wound Infection
Infection
Small Intestine
Colon

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology

Cite this

Kreis, D. J., Augenstein, D., Martinez, O., Echenique, M., Plasencia, G., Vopal, J. J., ... Gomez, G. A. (1986). A prospective randomized study of moxalactam versus gentamicin and clindamycin in penetrating abdominal trauma. Surgery Gynecology and Obstetrics, 163(1), 1-4.

A prospective randomized study of moxalactam versus gentamicin and clindamycin in penetrating abdominal trauma. / Kreis, D. J.; Augenstein, D.; Martinez, O.; Echenique, M.; Plasencia, G.; Vopal, J. J.; Byers, P.; Gomez, G. A.

In: Surgery Gynecology and Obstetrics, Vol. 163, No. 1, 1986, p. 1-4.

Research output: Contribution to journalArticle

Kreis, DJ, Augenstein, D, Martinez, O, Echenique, M, Plasencia, G, Vopal, JJ, Byers, P & Gomez, GA 1986, 'A prospective randomized study of moxalactam versus gentamicin and clindamycin in penetrating abdominal trauma', Surgery Gynecology and Obstetrics, vol. 163, no. 1, pp. 1-4.
Kreis DJ, Augenstein D, Martinez O, Echenique M, Plasencia G, Vopal JJ et al. A prospective randomized study of moxalactam versus gentamicin and clindamycin in penetrating abdominal trauma. Surgery Gynecology and Obstetrics. 1986;163(1):1-4.
Kreis, D. J. ; Augenstein, D. ; Martinez, O. ; Echenique, M. ; Plasencia, G. ; Vopal, J. J. ; Byers, P. ; Gomez, G. A. / A prospective randomized study of moxalactam versus gentamicin and clindamycin in penetrating abdominal trauma. In: Surgery Gynecology and Obstetrics. 1986 ; Vol. 163, No. 1. pp. 1-4.
@article{9b8e5a0e5bd54af3aecd977882d7312d,
title = "A prospective randomized study of moxalactam versus gentamicin and clindamycin in penetrating abdominal trauma",
abstract = "We conducted a randomized, prospective study of moxalactam versus gentamicin plus clindamycin in 42 patients with penetrating abdominal trauma. Patients were randomized to receive intravenously either 2 grams of moxalactam every 12 hours or 80 milligrams of gentamicin every eight hours and 600 milligrams of clindamycin every six hours. Antibiotics were administered preoperatively and continued for a minimum of five days if hollow viscus injury occurred. For those without hollow viscus injury, only those patients receiving a minimum of three days of antibiotics were evaluated. A single intramuscular dose of 10 milligrams of vitamin K was also administered to all patients in the moxalactam group. There were 39 males and three females with a mean age of 33 years. Twenty patients received moxalactam and 22 received gentamicin plus clindamycin. The mechanism of injury was gunshot wound in 32 patients and stab wounds in ten patients. Eight patients in each group sustained injuries to the small intestine or colon, or both. The mean injury severity score was 22.6 and 21.1 in the single and double antibiotic regimen, respectively. The mean duration of antibiotic therapy was 5.8 and 7.0 days in the single and double antibiotic group, respectively. No infectious complications occurred in the moxalactam group whereas five infections occurred in four patients in the gentamicin plus clindamycin group (p <0.05). These infections included one intra-abdominal abscess, two wound infections and two episodes of necrotizing fasciitis of the wound and abdominal wall. There were no complications attributable to moxalactam therapy. The over-all mortality rate was zero per cent. The total pharmacy cost of a five day course of moxalactam plus a single dose of vitamin K is $204.67 compared with $226.00 for a similar course of gentamicin plus clindamycin. We conclude that: 1, moxalactam is at least, if not more, effective in preventing infectious complications after penetrating abdominal trauma compared with gentamicin plus clindamycin; 2, moxalactam is safe in the doses used when combined with vitamin K, and 3, moxalactam is more cost-effective than gentamicin plus clindamycin dual antibiotic therapy.",
author = "Kreis, {D. J.} and D. Augenstein and O. Martinez and M. Echenique and G. Plasencia and Vopal, {J. J.} and P. Byers and Gomez, {G. A.}",
year = "1986",
language = "English (US)",
volume = "163",
pages = "1--4",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - A prospective randomized study of moxalactam versus gentamicin and clindamycin in penetrating abdominal trauma

AU - Kreis, D. J.

AU - Augenstein, D.

AU - Martinez, O.

AU - Echenique, M.

AU - Plasencia, G.

AU - Vopal, J. J.

AU - Byers, P.

AU - Gomez, G. A.

PY - 1986

Y1 - 1986

N2 - We conducted a randomized, prospective study of moxalactam versus gentamicin plus clindamycin in 42 patients with penetrating abdominal trauma. Patients were randomized to receive intravenously either 2 grams of moxalactam every 12 hours or 80 milligrams of gentamicin every eight hours and 600 milligrams of clindamycin every six hours. Antibiotics were administered preoperatively and continued for a minimum of five days if hollow viscus injury occurred. For those without hollow viscus injury, only those patients receiving a minimum of three days of antibiotics were evaluated. A single intramuscular dose of 10 milligrams of vitamin K was also administered to all patients in the moxalactam group. There were 39 males and three females with a mean age of 33 years. Twenty patients received moxalactam and 22 received gentamicin plus clindamycin. The mechanism of injury was gunshot wound in 32 patients and stab wounds in ten patients. Eight patients in each group sustained injuries to the small intestine or colon, or both. The mean injury severity score was 22.6 and 21.1 in the single and double antibiotic regimen, respectively. The mean duration of antibiotic therapy was 5.8 and 7.0 days in the single and double antibiotic group, respectively. No infectious complications occurred in the moxalactam group whereas five infections occurred in four patients in the gentamicin plus clindamycin group (p <0.05). These infections included one intra-abdominal abscess, two wound infections and two episodes of necrotizing fasciitis of the wound and abdominal wall. There were no complications attributable to moxalactam therapy. The over-all mortality rate was zero per cent. The total pharmacy cost of a five day course of moxalactam plus a single dose of vitamin K is $204.67 compared with $226.00 for a similar course of gentamicin plus clindamycin. We conclude that: 1, moxalactam is at least, if not more, effective in preventing infectious complications after penetrating abdominal trauma compared with gentamicin plus clindamycin; 2, moxalactam is safe in the doses used when combined with vitamin K, and 3, moxalactam is more cost-effective than gentamicin plus clindamycin dual antibiotic therapy.

AB - We conducted a randomized, prospective study of moxalactam versus gentamicin plus clindamycin in 42 patients with penetrating abdominal trauma. Patients were randomized to receive intravenously either 2 grams of moxalactam every 12 hours or 80 milligrams of gentamicin every eight hours and 600 milligrams of clindamycin every six hours. Antibiotics were administered preoperatively and continued for a minimum of five days if hollow viscus injury occurred. For those without hollow viscus injury, only those patients receiving a minimum of three days of antibiotics were evaluated. A single intramuscular dose of 10 milligrams of vitamin K was also administered to all patients in the moxalactam group. There were 39 males and three females with a mean age of 33 years. Twenty patients received moxalactam and 22 received gentamicin plus clindamycin. The mechanism of injury was gunshot wound in 32 patients and stab wounds in ten patients. Eight patients in each group sustained injuries to the small intestine or colon, or both. The mean injury severity score was 22.6 and 21.1 in the single and double antibiotic regimen, respectively. The mean duration of antibiotic therapy was 5.8 and 7.0 days in the single and double antibiotic group, respectively. No infectious complications occurred in the moxalactam group whereas five infections occurred in four patients in the gentamicin plus clindamycin group (p <0.05). These infections included one intra-abdominal abscess, two wound infections and two episodes of necrotizing fasciitis of the wound and abdominal wall. There were no complications attributable to moxalactam therapy. The over-all mortality rate was zero per cent. The total pharmacy cost of a five day course of moxalactam plus a single dose of vitamin K is $204.67 compared with $226.00 for a similar course of gentamicin plus clindamycin. We conclude that: 1, moxalactam is at least, if not more, effective in preventing infectious complications after penetrating abdominal trauma compared with gentamicin plus clindamycin; 2, moxalactam is safe in the doses used when combined with vitamin K, and 3, moxalactam is more cost-effective than gentamicin plus clindamycin dual antibiotic therapy.

UR - http://www.scopus.com/inward/record.url?scp=0022619878&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0022619878&partnerID=8YFLogxK

M3 - Article

VL - 163

SP - 1

EP - 4

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 1

ER -