Randomised study of prophylactic parenteral sulbactam/ampicillin and cephazolin in biliary surgery: Significant benefit in jaundiced patients

Two hundred consecutive patients undergoing biliary-tract surgery were entered into a randomized trial of prophylactic single dose cephazolin or sulbactam/ampicillin. There was no overall difference in the infection rates between the two antibiotic groups, but in the group of patients with jaundice there was an excess of wound infections in the cephazolin group compared to the sulbactam/ampicillin group (35% vs. 14%). We conclude that sulbactam/ampicillin is a satisfactory prophylactic agent for use in biliary-tract surgical sepsis, and that it may be superior to cephazolin in jaundiced patients.