ro13-9904 and Colonic-Neoplasms

Patients undergoing elective left colectomy for colonic carcinoma or diverticulosis (n = 341) were randomly assigned to three groups. Patients in groups 1 (102 patients) and 2 (122 patients) had two 5% povidone-iodine enemas whereas those in group 3 (117 patients) had saline enemas. Groups 1 and 3 received 24-hour intravenous cefotaxime sodium and metronidazole hydrochloride. Group 2 received single injections of ceftriaxone sodium (1 g) and ornidazole (1 g). Senna concentrate was administered the evening before surgery. There was no statistically significant difference found between groups 1 and 2 concerning the number of infected patients (eight vs 11), anastomotic leakages (four vs four), extra-abdominal complications (32 vs 29), or infection-related deaths (one vs zero). Despite poorer tolerance, povidone-iodine enema was more effective than saline enemas, as there were less infected patients in group 1 (8%) or groups 1 + 2 (8.5%) than in group 3 (13%). Single-dose ceftriaxone-ornidazole combined with povidone-iodine enemas is effective against infective complications in elective left colonic surgery for carcinoma or diverticular disease. Single-dose antibiotic prophylaxis reduces costs and work for the nursing staff.

Topics: Adult; Aged; Aged, 80 and over; Anastomosis, Surgical; Cefotaxime; Ceftriaxone; Colectomy; Colonic Neoplasms; Diverticulum, Colon; Drug Tolerance; Enema; Female; Humans; Male; Metronidazole; Middle Aged; Ornidazole; Povidone-Iodine; Prognosis; Risk Factors; Senna Extract; Surgical Wound Infection; Survival Rate

In an open, prospective, and randomized investigation on the prophylactic efficacy of peroral neomycin sulfate-erythromycin base vs intravenous ceftriaxone-metronidazole preparation in colorectal surgery, no significantly diverging results between regimens were recorded (1/27 [3.7%] and 2/27 [7.4%] wound infections, respectively). Commentary is made about the diverging results from earlier studies on antimicrobial prophylaxis and on the multifactorial causality of surgical infection. We believe that variables such as physical condition of the patients, virulence and local resistance patterns of bacteria, and technical skill of the surgeons are far more important in regard to the postoperative outcome concerning septic complications than is the choice of proper antibiotics. Thus, to determine the efficacy of antimicrobial prophylaxis, we call for larger investigations in the future, preferably double-blind, where it is possible to better control and diminish the influence of determinants other than the antibiotics being compared.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Ceftriaxone; Clinical Trials as Topic; Colonic Neoplasms; Drug Therapy, Combination; Erythromycin; Female; Humans; Injections, Intravenous; Male; Metronidazole; Middle Aged; Multicenter Studies as Topic; Neomycin; Premedication; Prospective Studies; Random Allocation; Rectal Neoplasms; Surgical Wound Infection

Topics: Adenocarcinoma; Adrenal Cortex Hormones; Aged; Anti-Bacterial Agents; Antineoplastic Agents; Arthritis, Infectious; Arthritis, Rheumatoid; Ceftriaxone; Colonic Neoplasms; Diabetes Mellitus, Type 2; Female; Gram-Negative Bacterial Infections; Hip Joint; Humans; Immunocompromised Host; Immunosuppressive Agents; Paracoccus; Ribotyping; RNA, Bacterial; RNA, Ribosomal, 16S; Synovial Fluid

The Lyme disease spirochete, Borrelia burgdorferi, can be recovered long after initial infection, even from antibiotic-treated patients, indicating that it resists eradication by host defense mechanisms and antibiotics. Since B. burgdorferi first infects skin, the possible protective effect of skin fibroblasts from an antibiotic commonly used to treat Lyme disease, ceftriaxone, was examined. Human foreskin fibroblasts protected B. burgdorferi from the lethal action of a 2-day exposure to ceftriaxone at 1 microgram/mL, 10-20 x MBC. In the absence of fibroblasts, organisms did not survive. Spirochetes were not protected from ceftriaxone by glutaraldehyde-fixed fibroblasts or fibroblast lysate, suggesting that a living cell was required. The ability of the organism to survive in the presence of fibroblasts was not related to its infectivity. Fibroblasts protected B. burgdorferi for at least 14 days of exposure to ceftriaxone. Mouse keratinocytes, HEp-2 cells, and Vero cells but not Caco-2 cells showed the same protective effect. Thus, several eukaryotic cell types provide the Lyme disease spirochete with a protective environment contributing to its long-term survival.

Topics: Adenocarcinoma; Animals; Borrelia burgdorferi; Borrelia burgdorferi Group; Carcinoma, Squamous Cell; Ceftriaxone; Cell Survival; Cells, Cultured; Colonic Neoplasms; Culture Media; Fibroblasts; Humans; Laryngeal Neoplasms; Mice; Tumor Cells, Cultured; Vero Cells

Topics: Ceftriaxone; Colonic Diseases; Colonic Neoplasms; Drug Administration Schedule; Drug Therapy, Combination; Humans; Nitroimidazoles; Ornidazole; Postoperative Complications; Surgical Wound Infection

Topics: Anti-Bacterial Agents; Cefotaxime; Ceftriaxone; Colonic Diseases; Colonic Neoplasms; Female; Humans; Male; Metronidazole; Middle Aged; Piperacillin; Premedication; Risk; Surgical Wound Infection