Optimal duration of prophylactic antibiotic administration for elective colon cancer surgery: A randomized, clinical trial.
BACKGROUND
Procedures for perioperative infection prophylaxis in elective colon cancer surgery consist of preoperative mechanical preparation, chemical preparation with oral antibiotic administration, perioperative intravenous antibiotic administration, and others. However, the optimal combination of these procedures and drugs and their durations of administration have not yet been established. A randomized study was conducted to determine the optimal duration of perioperative antibiotic administration with use of mechanical and chemical preparation.


METHODS
A total of 370 patients who were to undergo elective colon cancer surgery were randomized into 2 groups. After mechanical and chemical preparations, a single, 1-g dose of flomoxef was administered immediately before surgery to patients in group A. Flomoxef 1 g was administered twice daily for a total of 4 days from the day of surgery to postoperative day 3 to patients in group B.


RESULTS
Comparison was performed between 179 patients in group A and 181 patients in group B with analyzable data. The incidences of incisional surgical site infections (SSIs), organ/space SSIs, and remote infections (RIs) were 15 patients (8.4%), 1 patient (0.6%), and 8 patients (4.5%), respectively, in group A, and 13 patients (7.2%), 2 patients (1.1%), and 6 patients (3.3%), respectively, in group B. There were no differences in the incidence of incisional SSIs, organ/space SSIs, or RIs between groups A and B.


CONCLUSIONS
It was shown that a single dose of intravenous antibiotic immediately before surgery is sufficient as perioperative infection prophylaxis in elective colon cancer surgery when mechanical and chemical preparation is performed.
Suzuki
Toshiyuki
T
Department of Surgery, Tokai University, Isehara, Japan.
Sadahiro
Sotaro
S
Maeda
Yuji
Y
Tanaka
Akira
A
Okada
Kazutake
K
Kamijo
Akemi
A
D000368:Aged; D019072:Antibiotic Prophylaxis; D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control; D055499:Catheter-Related Infections / Q000517:prevention & control; D003110:Colonic Neoplasms / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D013997:Time Factors