Single-dose ceftriaxone, ornidazole, and povidone-iodine enema in elective left colectomy. A randomized multicenter controlled trial. The French Association for Surgical Research
A. Fingerhut and J. M. Hay
French Association for Surgical Research, Bois-Colombes.
Patients undergoing elective left colectomy for colonic carcinoma or
diverticulosis (n = 341) were randomly assigned to three groups. Patients
in groups 1 (102 patients) and 2 (122 patients) had two 5% povidone-iodine
enemas whereas those in group 3 (117 patients) had saline enemas. Groups 1
and 3 received 24-hour intravenous cefotaxime sodium and metronidazole
hydrochloride. Group 2 received single injections of ceftriaxone sodium (1
g) and ornidazole (1 g). Senna concentrate was administered the evening
before surgery. There was no statistically significant difference found
between groups 1 and 2 concerning the number of infected patients (eight vs
11), anastomotic leakages (four vs four), extra-abdominal complications (32
vs 29), or infection-related deaths (one vs zero). Despite poorer
tolerance, povidone-iodine enema was more effective than saline enemas, as
there were less infected patients in group 1 (8%) or groups 1 + 2 (8.5%)
than in group 3 (13%). Single-dose ceftriaxone-ornidazole combined with
povidone-iodine enemas is effective against infective complications in
elective left colonic surgery for carcinoma or diverticular disease.
Single-dose antibiotic prophylaxis reduces costs and work for the nursing
staff.
