Surgery Today 2010-10-01

Multicenter prospective randomized phase II study of antimicrobial prophylaxis in low-risk patients undergoing colon surgery.

Junzo Shimizu, Kimimasa Ikeda, Mutsumi Fukunaga, Kohei Murata, Atsushi Miyamoto, Koji Umeshita, Tetsuro Kobayashi, Morito Monden

Index: Surg. Today 40(10) , 954-7, (2010)

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Abstract

Postoperative antimicrobial therapy is generally administered as standard prophylaxis against postoperative infection, despite a lack of sufficient evidence for its usefulness. This study was a phase II study to evaluate the necessity of postoperative antibiotic prophylaxis in patients undergoing a colectomy.Patients received 1 g cefmetazole or flomoxef immediately after anesthetic induction, every 3 h during surgery, and then later once again on the next day. They were randomly assigned to receive either cefmetazole or flomoxef.Ninety-one patients were enrolled in the study. A surgical site infection (SSI) occurred in 7.7% (7/91) of patients. All cases were superficial incisional infections. When comparing the two drugs, SSI occurred in 8.3% (4/48) of patients treated with cefmetazole and in 7.0% (3/43) treated with flomoxef, showing no significant difference (P > 0.99).Antimicrobial prophylaxis was well tolerated when used on the day of a colectomy and once again on the next day.