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Article
April 1983

Efficacy of Oral and Systemic Antibiotic Prophylaxis in Colorectal Operations

Author Affiliations

From the Surgical and Research Services, Veterans Administration Medical Centers, Wood, Wis (Drs Condon and Schulte), Hines, Ill (Dr Greenlee), Buffalo (Dr Caruana), Los Angeles (Dr Gordon), Richmond, Va (Dr Horsley), Miami (Dr Irvin), Boston (Dr Johnson), Houston (Dr Jordan), Dallas (Dr Keitzer), Indianapolis (Dr Lempke), Little Rock, Ark (Dr Read), North Chicago, Ill (Dr Schumer), Minneapolis (Dr Schwartz), Sepulveda, Calif (Dr Storm), and Portland, Ore (Dr Vetto); the Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore (Dr Bartlett); the Cooperative Studies Coordinating Center, Hines (Dr Ochi); and the Surgical Service, US Naval Hospital, Great Lakes, Ill (Dr Abbe).

Arch Surg. 1983;118(4):496-502. doi:10.1001/archsurg.1983.01390040100021
Abstract

• A cooperative Veterans Administration study of the septic complication rate during large-bowel surgery was undertaken in two groups of patients. The first group received oral neomycin and erythromycin base plus parenteral placebo; the second, the oral antibiotics plus parenteral cephalothin sodium. During a five-year period, 1,128 patients were studied. The overall septic complication rate was 7.8% in patients receiving only oral antibiotics, and 5.7% in patients receiving both oral and parenteral antibiotics. This difference was not significant. The only significant finding was a greater incidence of fever of unknown origin in patients receiving only oral antibiotics. None of those patients were treated with additional antibiotics, and all fevers cleared spontaneously. There seems to be no discernible benefit from adding parenteral antibiotic prophylaxis when performing elective colon surgery if appropriate mechanical cleansing and oral neomycin and erthromycin therapy are employed.

(Arch Surg 1983;118:496-502)

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