Fosfomycin/metronidazole compared with doxycycline/metronidazole for the prophylaxis of infection after elective colorectal surgery. A randomised double-blind multicentre trial in 517 patients.
OBJECTIVE
To find out if fosfomycin together with metronidazole was any better than doxycycline with metronidazole for the prophylaxis of infection before elective colorectal operations.


METHODS
Multicentre, double blind, random control trial.


METHODS
Nine Swedish hospitals. SUBJECTS-559 patients admitted for elective colorectal operations.


METHODS
Fosfomycin 8 g and metronidazole 1 g before operation and fosfomycin 8 g eight hours afterwards, or doxycycline 400 mg and metronidazole 1 g before operation, and placebo eight hours afterwards.


METHODS
Incidence of all types of infection, mortality, and side effects.


RESULTS
There were no significant differences between the groups for any of the outcome measures studied, the overall abdominal infection rates (wound, deep, and septicaemia) being 4.6% and 7.4%, and the remote infection rates (pneumonia, urinary tract, and central venous line) 15.1% and 12.8%, respectively. Of the predictors studied, only duration of operation was significantly related to risk of infection.


CONCLUSIONS
The combination of fosfomycin and metronidazole was as safe and effective as that of doxycycline and metronidazole in preventing infections after elective colorectal operations.
Department of Surgery, Eksjö Hospital, Stockholm, Sweden.
L
L
Andåker
L G
LG
Burman
A
A
Eklund
H
H
Graffner
J
J
Hansson
R
R
Hellberg
H
H
Höjer
U
U
Ljungqvist
K
K
Kjellgren
P A
PA
Kling
D000368:Aged; D003106:Colon / Q000601:surgery*; D004311:Double-Blind Method; D004318:Doxycycline / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005578:Fosfomycin / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage*; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011183:Postoperative Complications / Q000517:prevention & control; D011292:Premedication / Q000379:methods*; D012007:Rectum / Q000601:surgery*
D008795:Metronidazole; D005578:Fosfomycin; D004318:Doxycycline