Document Detail

Failure of single-dose metronidazole prophylaxis in colorectal surgery. No benefit from high dosage or combination with nalidixic acid.
MedLine Citation:
PMID:  3287815     Owner:  NLM     Status:  MEDLINE    
In an open prospective study of postoperative infectious complications, patients undergoing elective colorectal surgery were randomly allocated to one of three groups receiving parenteral single-dose antimicrobial prophylaxis (1 g or 3 g metronidazole or 1 g metronidazole + 3 g nalidixic acid). Because of an unacceptably high rate of surgical infection in all three groups (36%, 29% and 39%, p greater than 0.1) among the first 103 evaluable patients, the study was discontinued. Nalidixic acid--though effective in in vitro tests of bacterial susceptibility--thus was found to be of little or no value as prophylaxis against Gram-negative infection. As the observed infection rate when metronidazole was given at the start of operation was seven-fold that previously found in the same department when 1 g metronidazole was administered 3-4 hours preoperatively (28/103 vs. 2/50, p less than 0.01), the timing of metronidazole prophylaxis was assumed to be potentially important for its ability to protect also against aerobic postoperative infection.
P A Kling; L G Burman
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta chirurgica Scandinavica     Volume:  154     ISSN:  0001-5482     ISO Abbreviation:  Acta Chir Scand     Publication Date:  1988 Apr 
Date Detail:
Created Date:  1988-07-06     Completed Date:  1988-07-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7906530     Medline TA:  Acta Chir Scand     Country:  SWEDEN    
Other Details:
Languages:  eng     Pagination:  305-9     Citation Subset:  IM    
Department of Surgery, University Hospital, Umeå, Sweden.
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MeSH Terms
Bacterial Infections / prevention & control*
Clinical Trials as Topic
Colon / surgery*
Drug Therapy, Combination
Metronidazole / administration & dosage*
Middle Aged
Nalidixic Acid / administration & dosage*
Postoperative Complications / prevention & control*
Prospective Studies
Random Allocation
Rectum / surgery*
Surgical Wound Infection / prevention & control
Reg. No./Substance:
389-08-2/Nalidixic Acid; 443-48-1/Metronidazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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