A Prospective Randomized Comparison of a Single Antibiotic (Moxalactam) Versus Combination Therapy (Gentamicin and Clindamycin) in Penetrating Abdominal Trauma

From July 1 to December 31, 1983, 50 consecutive patients undergoing abdominal exploration for penetrating abdominal trauma from stab and gunshot wounds were prospectively randomized to receive postinjury, preoperative antibiotic coverage with moxalactam (2 g intravenously every 12 hours) or a combination of gentamicin (3 to 5 mg/kg/day in three equal doses administered every eight hours) and clindamycin (600 mg intravenously every six hours). No intraabdominal abscesses or wound infections developed, and no direct evidence of toxicity of the antibiotic regimens developed in either group. In the study group, moxalactam therapy was an effective alternative to the combination antibiotic regimen. The subsequently documented incidence of moxalactam-induced bleeding episodes precludes its use as a primary preventive antibiotic; however, other less toxic cephalosporins may demonstrate similar effectiveness