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Fred A. Zar, MD
St Francis Hospital Evanston, III

JAMA. 1985;254(5):611.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

I enjoyed the STATE OF THE ART update on cesarean section written by Dr Danforth,¹ but must take issue with his suggested agent of choice for antimicrobial prophylaxis, namely, cefoxitin. In an era of cost containment it behooves physicians to choose the least expensive antibiotic, given their equal efficacy. There is ample evidence in the literature that either cefazolin or cefoxitin significantly decreases febrile morbidity after cesarean section when compared with placebo prophylaxis.² Only one adequately controlled study has compared these agents,³ and was referenced by Dr Danforth as support for cefoxitin as the agent of choice. Unfortunately, this study failed to show a significant difference (P<.05) between these drugs with respect to postoperative genital infections, standard fever index, standard febrile morbidity, or length of hospital stay.

There is no question as to the superior activity of cefoxitin compared to cefazolin against Bacteroides . . . [Full Text PDF of this Article]

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