Clostridial myonecrosis ('gas gangrene') during cephalosporin prophylaxis
J. A. Mohr, W. Griffiths, R. Holm, C. Garcia-Moral and D. J. Flournoy
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.
