Short-term intravenous antimicrobial prophylaxis in combination with preoperative oral antibiotics on surgical site infection and methicillin-resistant Staphylococcus aureus infection in elective colon cancer surgery: results of a prospective randomized trial.
OBJECTIVE
We performed a prospective randomized study to assess the effectiveness of short-term intravenous antimicrobial prophylaxis in combination with preoperative oral antibiotics on a surgical site and methicillin-resistant Staphylococcus aureus (MRSA) infection in elective colon cancer surgery.


METHODS
The patients were administered preoperative oral antibiotics, kanamycin and erythromycin, after mechanical cleansing, which began within 24 h of elective surgery for colon cancer. The patients were randomly assigned to receive the intravenous administration of cefmetazol or cefotiam on the day of surgery (group 1) or for 3 days (group 2). A total of 275 patients (136 for group 1 and 139 for group 2) were eligible for the study.


RESULTS
The incidence of a surgical site infection was 5.1% in group 1 and 6.5% in group 2 (P = 0.80). The incidence of MRSA infection was 2.2% in group 1 and 2.9% in group 2 (P > 0.99). A multivariate logistic regression analysis showed that the American Society of Anesthesiologists physical status score and the duration of surgery were independent significant factors affecting the surgical site infection and MRSA infection.


CONCLUSIONS
These findings suggest that short-term intravenous antimicrobial prophylaxis in combination with preoperative oral antibiotics may be successfully applied to colon cancer surgery that is generally performed in Japan.
Ishibashi
Keiichiro
K
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981 Tsujido-machi, Kamoda, Kawagoe, Saitama, 350-8550, Japan.
Kuwabara
Kouki
K
Ishiguro
Toru
T
Ohsawa
Tomonori
T
Okada
Norimichi
N
Miyazaki
Tatsuya
T
Yokoyama
Masaru
M
Ishida
Hideyuki
H
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007564:Japan; D016015:Logistic Models; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents