Prophylaxis with cefamandole nafate in elective orthopedic surgery.

A prospective, randomized, double-blind study was conducted to determine the efficacy of cefamandole nafate in reducing infections in general orthopedic procedures. Of 743 patients initially entered into the study, 715 (362 on cefamandole, 353 on placebo) fulfilled the requirements of the protocol. The infection rate was 1.6% for the cefamandole-treated group and 4.2% for the placebo group. In operations lasting longer than two hours, there were two infections in the cefamandole group and seven infections in the placebo group (p less than 0.05). Staphylococcus aureus and gram-negative bacilli were the common pathogens. Adverse side effects were limited to transient elevations in liver enzymes.