A prospective, randomized, double-blind studyof single high dose versus multiple standard dose gentamicin both in combination withmetronidazole for colorectal surgicalprophylaxis

The Journal of Hospital Infection
S A ZelenitskyG K Harding

Abstract

Single, high dose regimens of gentamicin plus metronidazole for colorectal surgical prophylaxis have not been adequately studied. Patients received single high dose gentamicin (4.5 mg/kg) plus metroni-dazole (500 mg) preoperatively or multiple standard dose gentamicin (1.5 mg/kg) plus metronidazole (500 mg) preoperatively and every 8h for 24h postoperatively. The deep surgical site infection (SSI) rates were 8.1% (6/74) and 6.9% (5/72) in the single high dose and multiple standard dose groups, respectively (P= 0.94). There was a trend towards fewer superficial SSIs in the single high dose group with infection rates of 18.9% (14/74) vs. 30.6% (22/72) (P= 0.05). Diabetes mellitus (odds ratio = 7.04) and surgery duration of longer than 3h (odds ratio = 5.46) were independent risk factors for the development of SSIs. A subset analysis of prolonged operations found significantly fewer superficial SSIs in the single high dose group than in the multiple standard dose group with rates of 22.2% (6/27) vs. 55% (11/20), respectively (P= 0.021). Single high dose gentamicin plus metronidazole preoperatively was at least as effective as the multiple standard dose regimen and may be more effective for prolonged operations.

References

Aug 1, 1988·The British Journal of Surgery·W Y LauK K Ho
Aug 1, 1995·The British Journal of Surgery·C S McArdleG S Tillotson
Jul 4, 1998·The Journal of Hospital Infection·A P WilsonG M Scott

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Citations

Mar 7, 2013·Surgical Infections·Dale W BratzlerUNKNOWN Society for Healthcare Epidemiology of America (SHEA)
Aug 17, 2002·Antimicrobial Agents and Chemotherapy·Sheryl A ZelenitskyRichard E Silverman
Dec 21, 2013·Enfermedades infecciosas y microbiología clínica·Angel Asensio
May 21, 2011·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·T KosakaN Fujita
Jan 25, 2011·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·P KnebelC M Seiler
Jun 19, 2016·British Journal of Anaesthesia·P C JutteS K Bulstra
Jul 13, 2016·The Journal of Antimicrobial Chemotherapy·S A ZelenitskyG G Zhanel
May 13, 2014·The Cochrane Database of Systematic Reviews·Richard L NelsonMarija Barbateskovic
Oct 12, 2014·Annals of Plastic Surgery·Richard LewinMattias Lidén

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