LOW-DOSE, SINGLE-SHOT PERIOPERATIVE ANTIBIOTIC-PROPHYLAXIS IN COLORECTAL SURGERY

Reductions of frequency of administration and dosage of antibiotic age nts used in colorectal surgery may lower cost and the occurrence of ad verse side effects. In a prospective randomized trial we evaluated two single-shot regimens, a low dose of 1 g cefotiam against a standard d ose of 2 g cefotiam, both in combination with 500 mg metronidazole. Th e low-dose group had twice the number of patients with wound sepsis (4 of 30) than the group receiving the standard antibiotic regimen (2 of 30). Two hours after infusion, the antibiotic concentrations in sampl es of serum, subcutaneous fatty tissue, and colonic wall of those pati ents receiving 1 g cefotiam were <1 mg/l. The concentrations after adm inistration of 2 g cefotiam were higher, as expected, and without any adverse side effects. In conclusion, we prefer infection prophylaxis b y the standard dose of 2 g cefotiam plus 500 mg metronidazole in color ectal surgery.