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Selective cefuroxime prophylaxis following colorectal surgery based on intra-operative dipslide culture

Claesson, B E; Filipsson, S; Holmlund, D E; Mätzsch, Thomas LU and Wahlby, L (1986) In British Journal of Surgery 73(12). p.953-957
Abstract
The concept of a very limited effective period for prophylactic antibiotic action was challenged in a prospective, controlled and randomized study featuring a simplified method for assessing the degree of contamination in the operative field during colorectal surgery. The 226 patients were given 1 g metronidazole IV on induction of anaesthesia and 12 h postoperatively. Following standardized saline irrigation of the abdominal cavity, a uriculture dipslide was dipped in the residual fluid just before abdominal closure. The dipslide was incubated for 18 h, and colony counts of coliforms and Staphylococcus aureus were made. The number of colony-forming units (CFU) was classified as 0, 1-4 or greater than or equal to 5 (n = 123, 33 and 70).... (More)
The concept of a very limited effective period for prophylactic antibiotic action was challenged in a prospective, controlled and randomized study featuring a simplified method for assessing the degree of contamination in the operative field during colorectal surgery. The 226 patients were given 1 g metronidazole IV on induction of anaesthesia and 12 h postoperatively. Following standardized saline irrigation of the abdominal cavity, a uriculture dipslide was dipped in the residual fluid just before abdominal closure. The dipslide was incubated for 18 h, and colony counts of coliforms and Staphylococcus aureus were made. The number of colony-forming units (CFU) was classified as 0, 1-4 or greater than or equal to 5 (n = 123, 33 and 70). The patients with CFU greater than or equal to 5 were randomized to receive cefuroxime (1.5 g IV/8 h for 2 days) or no more antibiotics. In the patients given only metronidazole, the incidence of postoperative infections rose with the colony counts (5.7, 9.1 and 41.2 per cent with CFU 0, 1-4 and greater than or equal to 5). Addition of cefuroxime reduced the 41.2 per cent infection rate to 8.3 per cent (P = 0.003). The method thus identified a high-risk group in which a short postoperative course of cefuroxime significantly lowered the rate of sepsis. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Selective antibiotic prophylaxis, cefuroxime, metronidazole, dipslide culture, colorectal surgery
in
British Journal of Surgery
volume
73
issue
12
pages
953 - 957
publisher
John Wiley & Sons
external identifiers
  • pmid:3790956
  • scopus:0023000158
ISSN
1365-2168
DOI
10.1002/bjs.1800731204
language
English
LU publication?
yes
id
4e747cec-0ee2-4ab6-955f-0559c168e9d8 (old id 1103602)
date added to LUP
2008-08-11 09:42:24
date last changed
2017-01-01 04:51:43
@article{4e747cec-0ee2-4ab6-955f-0559c168e9d8,
  abstract     = {The concept of a very limited effective period for prophylactic antibiotic action was challenged in a prospective, controlled and randomized study featuring a simplified method for assessing the degree of contamination in the operative field during colorectal surgery. The 226 patients were given 1 g metronidazole IV on induction of anaesthesia and 12 h postoperatively. Following standardized saline irrigation of the abdominal cavity, a uriculture dipslide was dipped in the residual fluid just before abdominal closure. The dipslide was incubated for 18 h, and colony counts of coliforms and Staphylococcus aureus were made. The number of colony-forming units (CFU) was classified as 0, 1-4 or greater than or equal to 5 (n = 123, 33 and 70). The patients with CFU greater than or equal to 5 were randomized to receive cefuroxime (1.5 g IV/8 h for 2 days) or no more antibiotics. In the patients given only metronidazole, the incidence of postoperative infections rose with the colony counts (5.7, 9.1 and 41.2 per cent with CFU 0, 1-4 and greater than or equal to 5). Addition of cefuroxime reduced the 41.2 per cent infection rate to 8.3 per cent (P = 0.003). The method thus identified a high-risk group in which a short postoperative course of cefuroxime significantly lowered the rate of sepsis.},
  author       = {Claesson, B E and Filipsson, S and Holmlund, D E and Mätzsch, Thomas and Wahlby, L},
  issn         = {1365-2168},
  keyword      = {Selective antibiotic prophylaxis,cefuroxime,metronidazole,dipslide culture,colorectal surgery},
  language     = {eng},
  number       = {12},
  pages        = {953--957},
  publisher    = {John Wiley & Sons},
  series       = {British Journal of Surgery},
  title        = {Selective cefuroxime prophylaxis following colorectal surgery based on intra-operative dipslide culture},
  url          = {http://dx.doi.org/10.1002/bjs.1800731204},
  volume       = {73},
  year         = {1986},
}