Comparison of metronidazole with clindamycin-gentamycin combination in the prevention of infectious complications after elective colonic surgery.
The efficacy of metronidazole, active only against anaerobes, and clindamycin-gentamycin combination, covering both anaerobes and aerobes, in the prevention of infectious complications after elective colonic surgery was compared in a prospective randomized trial over a three-year period. A total of 130 patients were accepted for the trial, 67 receiving metronidazole intrarectally and 63 receiving clindamycin-gentamycin combination. The prophylactic treatment was started on the evening before the operation and continued for 24 hours. One patient out of 67 receiving metronidazole (1.5%) and two patients out of 63 receiving clindamycin-gentamycin (3.2%) developed a wound infection. An intra-abdominal infection occurred in two patients in both groups (3% and 3.2%, respectively). There was no statistically significant difference in postoperative infections between the groups. The authors conclude that metronidazole is as effective as the clindamycin-gentamycin combination and should be preferred to broad-spectrum antibiotics because of its fewer side effects and lower potential of developing resistant bacterial strains.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002981:Clindamycin / Q000008:administration & dosage*; D003108:Colonic Diseases / Q000601:surgery*; D004359:Drug Therapy, Combination; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage*; D008875:Middle Aged; D011446:Prospective Studies; D011897:Random Allocation; D013488:Suppositories; D013530:Surgical Wound Infection / Q000517:prevention & control*
D005839:Gentamicins; D013488:Suppositories; D008795:Metronidazole; D002981:Clindamycin