Antibiotic prophylaxis in oesophageal surgery.
A prospective randomised study to assess the efficacy of antibiotic prophylaxis in oesophageal surgery was performed, in which 226 consecutive patients (113 male and 113 female, age range 24-86 years, mean age of 65 years) were included. The study patients were in two groups: group 1, in which the upper alimentary tract was opened during surgery, and group 2, in which it was not. The group 1 patients (n = 129) were randomised to one of three antibiotic prophylaxis regimes prior to surgery. Group A patients (n = 42) were treated with cefuroxime (CFX) 1.5 g at induction of anaesthesia and then CFX 750 mg b.i.d. for 4 days. Group B patients (n = 46) were treated with CFX 1.5 g and metronidazole (MTR) 1.0 g at induction of anaesthesia, then CFX 750 mg b.i.d. and MTR 500 mg qds for 4 days. Group C (n = 41) treated with CFX 1.5 g and MTR 1.0 g at the induction of anaesthesia. Group 2 (n = 97) was divided into two groups, group D (n = 47) treated with CFX 1.5 g on induction of anaesthesia alone. Group E (n = 50) treated with CFX 1.5 g on induction of anaesthesia then CFX 750 mg bd for 2 days. We found a significantly higher incidence of infective complications in subgroup C (43.9%) and subgroup A (21.4%) compared to subgroup B (8.6%). This difference was most marked in patients undergoing oesophagectomy. We found significantly higher infection rates of infective complications in subgroup D (10.6%) as compared to subgroup E (2%).
Sharpe
D A
DA
North Humberside Cardiothoracic Centre, Castle Hill Hospital, Cottingham, UK.
Renwick
P
P
Mathews
K H
KH
Moghissi
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011292:Premedication; D011446:Prospective Studies
D000900:Anti-Bacterial Agents