Trimethoprim-sulphamethoxazole and metronidazole as prophylaxis in colorectal surgery: a study of bioavailability after an oral single dose.
OBJECTIVE
To evaluate oral single dose prophylaxis in colorectal surgery.


METHODS
Prospective study.


METHODS
University hospital, Sweden.


METHODS
24 patients (13 women; 11 men; mean age 57 years, range 27-81) listed for elective colorectal operations.


METHODS
At 0630 on the day of the operation all patients were given an oral dose of trimethoprim-sulphamethoxazole (TMP 160 mg and SMZ 800 mg) and metronidazole (2 g). The serum concentrations of TMP and SMZ were analysed in venous samples taken at the start and end of each operation.


RESULTS
The earliest operation started at 0830 and the last finished at 1700. The median (range) serum concentrations of TMP were 1.4 (0.7-2.6) mg/L (start) and 1.3 (1.0-2.8) mg/L (end), and of SMZ 35 (15-65) mg/L (start) and 33 mg (13-70) mg/L (end). The individual values were above or equal to the minimal inhibitory concentration (TMP 0.8 mg/L; SMZ 15.2 mg/L) for relevant gram-negative species.


CONCLUSIONS
Oral TMP/SMZ in the morning gives satisfactory serum concentrations independently of when the operation is done during the day. The regimen is simple and has the potential for being an effective alternative to intravenous prophylaxis.
Raab
Y
Y
Department of Surgery, University Hospital, Uppsala, Sweden.
Rasmussen
I
I
Odenholt
I
I
Påhlman
L
L
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics*; D001682:Biological Availability; D003107:Colorectal Surgery / Q000009:adverse effects*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics*; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics*
D000890:Anti-Infective Agents; D008795:Metronidazole; D015662:Trimethoprim, Sulfamethoxazole Drug Combination