Single-dose antibiotic prophylaxis is effective enough in colorectal surgery

Abstract

Background: The aim of this study was to investigate the hypothesis that prevention of surgical site infection (SSI) is equally effective when patients receive single?dose (SD) or three?dose antibiotic prophylaxis with second?generation cephalosporin and metronidazole in elective colorectal surgery.Methods: Ninety?three patients were enrolled from May 2009 to November 2010. The SD group received only one preoperative prophylactic intravenous dose and the three?dose or multiple?dose (MD) group received one preoperative prophylactic and two additional post?operative doses of second?generation cephalosporin and metronidazole. The incidence of infectious complications (SSI of the incision site and organ/space) was compared in the two groups.Results: The overall post?operative infection rate did not differ between the two groups (16.7% in the SD versus 13.3% in the MD, P = 0.653). The incidence of SSI of the incision site and organ/space also did not differ between the groups (6.3% (3/48) versus 4.4% (2/45), P = 0.700; 4.2% versus 6.7%, P = 0.593, respectively). The number of antibiotics administered was not an independent risk factor for SSIs in multivariable analysis.Conclusions: SD antibiotic prophylaxis with second?generation cephalosporin and metronidazole is equivalent to a three?dose prophylaxis for preventing SSI in elective colorectal surgery. But further study would be needed to clarify this because of the small number of participants.