Ertapenem was more effective than cefotetan, but head-to-head comparisons with other common antibiotics would be valuable.
Antibiotic prophylaxis is common before surgical procedures and also is used before direct percutaneous placement of gastrostomy and jejunostomy tubes. U.S. researchers conducted an industry-sponsored, randomized, double-blind trial at 51 centers to compare the efficacy of ertapenem (a group 1 carbapenem antibiotic) with that of cefotetan among 901 adult patients who were undergoing colon surgery.
The prophylactic failure rate was high in both treatment groups, probably because the failure definition included anastomotic leaks and requirement for additional antibiotics within 4 weeks. In an intent-to-treat analysis, the failure rates were 50.9% in the cefotetan group and 40.2% in the ertapenem group (difference, –10.7%; 95% CI, –17.1% to –4.…