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Short-term chemoprophylaxis with ceftizoximevs. Five-day aminoglycoside with metronidazole in ‘contaminated’ lower gastrointestinal surgery

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Diseases of the Colon & Rectum

Abstract

In a prospective, open, randomized controlled trial, 173 patients requiring surgery for potentially “contaminated” lower gastrointestinal surgery were allocated to receive either two doses of ceftizoxime (2 gm) with one dose of metronidazole (1.5 gm) or gentamicin 3 mg/kg/day for five days with one dose of metronidazole (1.5 gm). Eighty-nine patients received ceftizoxime and 84 patients received gentamicin. The groups were comparable with respect to diagnosis, procedure, type of anastomosis, and wound closure. The incidence of withdrawal due to failure to respond to the study drug (11.5 percent) was equivalent in the two groups. There was no difference in the overall incidence of postsurgical infection between the ceftizoxime and metronidazole group (22.2 percent) and the gentamicin and metronidazole group (25.7 percent). The incidence of wound infection (ceftizoxime and metronidazole, 6.9 percent; gentamicin and metronidazole, 10 percent) and deep sepsis (ceftizoxime and metronidazole, 15.3 percent; gentamicin and metronidazole, 15.7 percent) was similar.

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References

  1. Hares MM, Bentley S, Allan RN, Burdon DW, Keighley MR. Clinical trials of the efficacy and duration of antibacterial cover for elective resection in inflammatory bowel disease. Br J Surg 1982;69:215–7.

    PubMed  CAS  Google Scholar 

  2. Ambrose NS, Alexander-Williams J, Keighley MR. Audit of sepsis in operations for inflammatory bowel disease. Dis Colon Rectum 1984;27:602–4.

    PubMed  CAS  Google Scholar 

  3. Tudor RG, Haynes I, Youngs DJ, Burdon DW, Keighley MR. Comparison of short-term antibiotic cover with a third generation cephalosporin against conventional five-day therapy using metronidazole with an aminoglycoside in emergency and complicated colorectal surgery. Dis Colon Rectum 1988;31:28–32.

    PubMed  CAS  Google Scholar 

  4. Higgens C, Allan RN, Keighley MR, Arabi Y, Alexander-Williams J. Sepsis following operation for inflammatory intestinal disease. Dis Colon Rectum 1980;23:102–5.

    PubMed  CAS  Google Scholar 

  5. Burton RC. Postoperative wound infection in colonic and rectal surgery. Br J Surg 1973;60:363–5.

    PubMed  CAS  Google Scholar 

  6. Keighley MR, Arabi Y, Alexander-Williams J,et al. Comparison between systemic and oral antimicrobial prophylaxis in colorectal surgery. Lancet 1979;1:894–7.

    PubMed  CAS  Google Scholar 

  7. Willis AT, Ferguson IR, Jones PH,et al. Metronidazole in prevention and treatment of bacteroides in elective colonic surgery. Br Med J 1977;1:607–10.

    Article  PubMed  CAS  Google Scholar 

  8. Downing R, McLeish AR, Burdon DW, Alexander-Williams J, Keighley MR. Duration of systemic prophylactic antibiotic cover against anaerobic sepsis in intestinal surgery. Dis Colon Rectum 1977;20:401–4.

    PubMed  CAS  Google Scholar 

  9. Eykyn SJ, Jackson BT, Lockhard-Mummery HC,et al. Prophylactic preoperative intravenous metronidazole in elective colorectal surgery. Lancet 1979;2:761–3.

    PubMed  CAS  Google Scholar 

  10. Morris DL, Fabricius PJ, Ambrose NS, Scammell B, Burdon DW, Keighley MR. A high incidence of bleeding is observed in a trial to determine whether addition of metronidazole is needed with latamoxef for prophylaxis in colorectal surgery. J Hosp Infect 1984;5:398–405.

    PubMed  CAS  Google Scholar 

  11. Hares MM, Greca F, Youngs D, Bentley D, Burdon DW, Keighley MR. Failure of antimicrobial prophylaxis with cefoxitus or metronidazole and gentamicin in colorectal surgery: is mannitol to blame? J Hosp Infect 1981;2:127–33.

    PubMed  CAS  Google Scholar 

  12. Keighley MR. Antibiotic associated pseudomembraneous colitis: pathogenesis and management. Drug 1980;20:49–56.

    CAS  Google Scholar 

  13. Ambrose NS, Burdon DW, Keighley MR. A prospective randomized trial to compare mezlocillin and metronidazole with cefuroxime and metronidazole in elective colorectal operations. J Hosp Infect 1983;4:375–82.

    PubMed  CAS  Google Scholar 

  14. Ambrose NS, Johnson M, Burdon DW, Keighley MR. The influence of single dose intravenous antibiotics on faecal flora and emergence ofClostridium difficile. J Antimicrob Chemother 1985;15:319–26.

    PubMed  CAS  Google Scholar 

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Winslet, M.C., Youngs, D., Burdon, D.W. et al. Short-term chemoprophylaxis with ceftizoximevs. Five-day aminoglycoside with metronidazole in ‘contaminated’ lower gastrointestinal surgery. Dis Colon Rectum 33, 878–882 (1990). https://doi.org/10.1007/BF02051926

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