Clostridial myonecrosis ('gas gangrene') during cephalosporin prophylaxis

JAMA. 1978 Feb 27;239(9):847-9.

Abstract

Four cases of clostridial myonecrosis that developed in open fractures were treated with surgical debridement and with intravenous cephalosporins as antibiotic prophylaxis. All patients recovered following amputation of the involved extremity, and treatment with high-dose penicillin in three cases, and erythromycin plus high-dose cephalothin in the fourth. This complication was not seen in patients with similar injuries that were managed surgically but used other antibiotics, usually penicillin, as prophylaxis. In vitro susceptibility tests of clostridia to cephalothin were performed; the results demonstrated that nearly 50% of clostridia tested were resistant to cephalothin.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cephalothin / administration & dosage
  • Cephalothin / pharmacology*
  • Cephalothin / therapeutic use
  • Clostridium / drug effects*
  • Clostridium Infections / prevention & control*
  • Erythromycin / pharmacology
  • Female
  • Fractures, Open / drug therapy
  • Gas Gangrene* / etiology
  • Humans
  • Middle Aged
  • Penicillin Resistance
  • Penicillins / pharmacology

Substances

  • Penicillins
  • Erythromycin
  • Cephalothin