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Prophylactic Antibiotics in Colon SurgeryCephaloridine v Erythromycin and Neomycin
H. Turner Edmondson, MD;
J. Peter Rissing, MD
Arch Surg. 1983;118(2):227-231.
Abstract
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• One hundred twenty-three patients undergoing elective colon surgery were prospectively and randomly assigned to receive either three 1-g perioperative doses of intramuscular cephaloridine or three 1-g preoperative doses of both oral erythromycin base and neomycin sulfate. All patients had their bowels thoroughly cleansed mechanically. The groups were comparable in age and nutritional status. Eight wound infections occurred in the 65 patients receiving cephaloridine (12.3%) v one in the 58 receiving erythromycin and neomycin (1.7%). This difference was statistically significant. Eight of nine infected patients had only wound infections; the majority of cultures yielded Bacteroides fragilis. Serum and tissue antimicrobial concentrations were determined in the first 70 randomized patients at operation. Mean (±SD) cephaloridine levels were 14.7±10.2 and 10.5±10.0 mg/L in serum and tissue, respectively, compared with 1.98±1.58 and 0.699±1.146 mg/L for serum and tissue erythromycin levels.
(Arch Surg 1983;118:227-231)
Author Affiliations
From the Surgical (Dr Edmondson) and Medical (Dr Rissing) Services, Veterans Administration Medical Center and the Medical College of Georgia, Augusta.
Footnotes
Accepted for publication Nov 8, 1982.
Read before the second annual meeting of the Surgical Infection Society, Boston, April 20, 1982.
Reprint requests to Surgical Service, Veterans Administration Medical Center, Augusta, GA 30910 (Dr Edmondson).
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