A multicenter randomized trial of prophylaxis with intravenous cefepime + metronidazole or ceftriaxone + metronidazole in colorectal surgery. The 230 Study Group

We compared two prophylactic antimicrobial regimens in 615 patients undergoing elective colorectal surgical procedures. Patients ranged in age from 19 to 92 years (median 66 years); the majority were male (54.0%) and most (77.7%) had neoplastic disease. All underwent mechanical bowel preparation. Pa...

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Bibliographic Details
Published in:Journal of chemotherapy (Florence) 2000-02, Vol.12 (1), p.63
Main Authors: Zanella, E, Rulli, F
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anti-Infective Agents - administration & dosage
Anti-Infective Agents - adverse effects
Anti-Infective Agents - therapeutic use
Antibiotic Prophylaxis
Ceftriaxone - administration & dosage
Ceftriaxone - adverse effects
Ceftriaxone - therapeutic use
Cephalosporins - administration & dosage
Cephalosporins - adverse effects
Cephalosporins - therapeutic use
Colorectal Surgery
Drug Therapy, Combination
Female
Humans
Infusions, Intravenous
Male
Metronidazole - administration & dosage
Metronidazole - adverse effects
Metronidazole - therapeutic use
Middle Aged
Surgical Wound Infection - prevention & control
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Summary:We compared two prophylactic antimicrobial regimens in 615 patients undergoing elective colorectal surgical procedures. Patients ranged in age from 19 to 92 years (median 66 years); the majority were male (54.0%) and most (77.7%) had neoplastic disease. All underwent mechanical bowel preparation. Patients were randomized to receive preoperative infusions of 2 g cefepime (n=307) or 2 g ceftriaxone (n=308), followed by 500 mg metronidazole. Patients were followed for up to 4 to 6 weeks after surgery. Antimicrobial prophylaxis was successful in preventing primary site infections in 92.8% of patients in the cefepime + metronidazole arm and 92.9% of patients in the ceftriaxone + metronidazole arm. Both regimens were well tolerated. A single dose of cefepime + metronidazole thus seems to be a very useful alternative to other regimens for prophylaxis in patients undergoing colorectal surgery.
ISSN:1120-009X