cefamandole and Colonic-Neoplasms

The impact on wound infection of the addition of perioperative cefamandole to a mechanical bowel preparation with oral antibiotics was studied in a prospective randomized series of patients undergoing elective colectomy for biopsy-proven carcinoma or adenomatous polyps. Seventy patients were randomized, all underwent mechanical bowel preparation and received oral neomycin and erythromycin base. Thirty-four patients also received a preoperative and four postoperative doses of cefamandole, while 36 patients were randomized to receive no parenteral antibiotics. The two groups were well stratified for age, sex, and risk factors. The Dukes stage was similar and the surgical procedures were equally distributed in the two groups. There were no wound infections in the 34 patients receiving cefamandole and only one wound infection (2.8 percent) in the 36 control patients. Therefore, the addition of perioperative intravenous cefamandole to a good mechanical bowel preparation with oral antibiotics was of no benefit in reducing wound infections following resection of colorectal malignancies in this select group of patients.

Topics: Carcinoma, Squamous Cell; Cefamandole; Colonic Neoplasms; Colonic Polyps; Female; Humans; Intestinal Polyps; Male; Middle Aged; Premedication; Prospective Studies; Random Allocation; Rectal Neoplasms; Surgical Wound Infection

Thirty-four patients undergoing elective colon resection or anastomosis received either intravenous cephalothin or cefamandole prophylactically and were observed for evidence of intraabdominal or wound infection, or both, postoperatively. The infection rates were 31 and 33 per cent, respectively. Infections were caused predominantly by cephalosporin resistant aerobes and anaerobes. All four bacteremias were caused by members of the B. fragilis group. The overall infection rate (32 per cent) and the frequency of anaerobic bacteremia (12 per cent) observed in this study were much higher than previously reported after cephalosporin prophylaxis for colorectal surgery.

Topics: Adenoma; Adult; Aged; Cefamandole; Cephalosporins; Cephalothin; Clinical Trials as Topic; Colon; Colonic Neoplasms; Crohn Disease; Female; Humans; Injections, Intravenous; Intestinal Polyps; Male; Middle Aged; Surgical Wound Infection