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Comparative Study
. 2009 Dec 7:9:17.
doi: 10.1186/1471-2482-9-17.

Increased incidence of postoperative infections during prophylaxis with cephalothin compared to doxycycline in intestinal surgery

Gunnar Baatrup  1 , Roy M Nilsen, Rune Svensen, Per E Akselsen
Affiliations
Comparative Study

Increased incidence of postoperative infections during prophylaxis with cephalothin compared to doxycycline in intestinal surgery

Gunnar Baatrup et al. BMC Surg. .

Abstract

Background: The antibiotics used for prophylaxis during surgery may influence the rate of surgical site infections. Tetracyclines are attractive having a long half-life and few side effects when used in a single dose regimen. We studied the rate of surgical site infections during changing regimens of antibiotic prophylaxis in medium and major size surgery.

Methods: Prospective registration of surgical site infection following intestinal resections and hysterectomies was performed. Possible confounding procedure and patient related factors were registered. The study included 1541 procedures and 1489 controls. The registration included time periods when the regimen was changed from doxycycline to cephalothin and back again.

Results: The SSI in the colorectal department increased from 19% to 30% (p=0.002) when doxycycline was substituted with cephalothin and decreased to 17% when we changed back to doxycycline (p=0.005). In the gynaecology department the surgical site infection rate did not increase significantly. Subgroup analysis showed major changes in infections in rectal resections from 20% to 35% (p=0.02) and back to 12% (p=0.003).

Conclusion: Doxycycline combined with metronidazole, is an attractive candidate for antibiotic prophylaxis in medium and major size intestinal surgery.

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Figures

Figure 1
Figure 1
SSI rates according to patient group and period of observation. Period 1 was the first period of treatment with doxycycline and metronidazole (white bars). Period 2 was the period when cephalothin and metronidazole was used (grey bars). Period 3 was the period when we returned to doxycycline and metronidazole (black bars). The gynaecology department continued use of cephalothin and metronidazole during period 3 (i.e., same regimen during period 2 and 3). The obstetric (control) patients did not change the antibiotic regimen during the study period (i.e., hatched bars). Detailed data are provided in Additional File 2.
See this image and copyright information in PMC

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References

    1. Smith RL, Bohl JK, McElearney ST, Friel CM, Barclay MM, Sawyer RG, Foley EF. Wound infection after elective colorectal resection. Ann Surg. 2004;239:599–605. doi: 10.1097/01.sla.0000124292.21605.99. - DOI - PMC - PubMed
    1. Kobayashi M, Mohri Y, Tonouchi H, Miki C, Nakai K, Kusunoki M. Randomized clinical trial comparing intravenous antimicrobial prophylaxis alone with oral and intravenous antimicrobial prophylaxis for the prevention of a surgical site infection in colorectal cancer surgery. Surg Today. 2007;37:383–388. doi: 10.1007/s00595-006-3410-7. - DOI - PubMed
    1. Itani KM, Wilson SE, Awad SS, Jensen EH, Finn TS, Abramson MA. Ertapenem versus cefotetan prophylaxis in elective colorectal surgery. N Engl J Med. 2006;355:2640–2651. doi: 10.1056/NEJMoa054408. - DOI - PubMed
    1. Skipper D, Karran SJ. A randomized prospective study to compare cefotetan with cefuroxime plus metronidazole as prophylaxis in elective colorectal surgery. J Hosp Infect. 1992;21:73–77. doi: 10.1016/0195-6701(92)90155-F. - DOI - PubMed
    1. Fujita S, Saito N, Yamada T, Takii Y, Kondo K, Ohue M, Ikeda E, Moriya Y. Randomized, multicenter trial of antibiotic prophylaxis in elective colorectal surgery: single dose vs 3 doses of a second-generation cephalosporin without metronidazole and oral antibiotics. Arch Surg. 2007;142:657–661. doi: 10.1001/archsurg.142.7.657. - DOI - PubMed

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