Comparative analysis of two regimens of antibiotic prophylaxis in elective colorectal surgery.
BACKGROUND
Antibiotic prophylaxis has greatly reduced the rate of postoperative infectious complications since its utilization in the elective colorectal surgery in the last several decades. Although the need of its application is indisputable, the optimal duration of antibiotic prophylaxis is still on debate.


OBJECTIVE
The aim of the present study was to compare two regimens of antibiotic prophylaxis with different duration.


METHODS
A retrospective clinical study was conducted of 190 patients that underwent elective surgery for colorectal carcinoma in the Clinic between January 1997 and June 2000. The patients were divided into two groups according to the regimen of antibiotic prophylaxis. Group 1 (n = 92) patients received a 24-hour antibiotic prophylaxis and Group 2 (n = 98) had a prolonged antibiotic cover that lasted 5 days. The antibiotic prophylaxis was conducted with a third generation cefalosporin and metronidazole.


RESULTS
Of all 190 patients 92 were in Group 1 and 98 in Group 2. Postoperative infectious wound complications were found in 14 (15.2%) patients from Group 1 and in 25 (25.5%) patients from Group 2. The difference did not reach statistical significance (P > 0.05).


CONCLUSIONS
The results of the study show no advantage of the prolonged over short-term antibiotic prophylaxis. Based on the study findings the authors suggest that a 24-hour antibiotic prophylaxis should be recommended for the lower rate of side effects and lower cost.
Todorov
Anton T
AT
Department of General Surgery and Coloproctology, Medical University, 15A Vassil Aprilov St., 4000 Plovdiv, Bulgaria.
Manchev
Ivan D
ID
Atanassov
Chavdar B
CB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D001424:Bacterial Infections / Q000517:prevention & control*; D015179:Colorectal Neoplasms / Q000601:surgery*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents