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Efficacy of oral ofloxacin for single-dose perioperative prophylaxis in general surgery--a controlled randomized
M Schwarz1, R Isenmann, J Thomsen
1Department of General Surgery, University of Ulm, Steinhoevelstrasse 9, 89075 Ulm, Germany.
Background:
Perioperative antibiotic prophylaxis surely reduces surgical infection rate. Pharmacokinetic data of oral ofloxacin in combination with its antibacterial spectrum suggest effective protection against perioperative infection. In addition, costs, adverse effects, and induction of microbial resistance are low. Therefore we performed a controlled randomized study comparing oral and intravenous single dose prophylaxis.
Methods:
A total of 61 patients undergoing colonic or pancreatic resection randomly received either a single dose standard intravenous prophylaxis or ofloxacin 400 mg and metronidazole 500 mg orally 2 h before surgery. Postoperative infections were recorded for 3 weeks.
Results:
Groups were very well comparable regarding age, overweight, concomitant disease, type and duration of surgery, blood loss, and volume support. Infectious complications occurred in 14.8% after parenteral and 3.3% after enteral antibiotic prophylaxis. There was no difference in post-operative hospital stay.
Conclusion:
The data demonstrate that single-dose oral ofloxacin is at least as effective as a standard intravenous prophylaxis in patients with colonic or pancreatic resection. It offers significant advantages regarding costs and ease of administration.
Insights
Oral ofloxacin and metronidazole provide effective perioperative antibiotic prophylaxis for colonic or pancreatic resection patients. This single-dose oral regimen is as effective as intravenous prophylaxis, with lower costs and easier administration.
Area of Science:
- Surgical Infection Prevention
- Pharmacology
- Clinical Trials
Background:
- Perioperative antibiotic prophylaxis is crucial for reducing surgical site infections.
- Oral ofloxacin demonstrates favorable pharmacokinetic properties and antibacterial spectrum for infection prophylaxis.
- Low costs, minimal adverse effects, and reduced microbial resistance induction are associated with oral ofloxacin.
Purpose of the Study:
- To compare the efficacy of single-dose oral ofloxacin versus standard intravenous prophylaxis in patients undergoing colonic or pancreatic resection.
- To evaluate the safety and cost-effectiveness of oral antibiotic prophylaxis.
Main Methods:
- A randomized controlled study involving 61 patients undergoing colonic or pancreatic resection.
- Patients received either standard intravenous prophylaxis or a single oral dose of ofloxacin (400 mg) and metronidazole (500 mg) 2 hours pre-surgery.
- Postoperative infections were monitored for 3 weeks.
Main Results:
- Infectious complications occurred in 14.8% of patients receiving parenteral prophylaxis versus 3.3% receiving oral prophylaxis.
- No significant difference in postoperative hospital stay was observed between the groups.
- Patient demographics and surgical characteristics were comparable between the treatment groups.
Conclusions:
- Single-dose oral ofloxacin is a viable and effective alternative to standard intravenous prophylaxis for colonic and pancreatic resections.
- Oral prophylaxis offers significant advantages in terms of cost and ease of administration.
- This approach contributes to optimizing perioperative care and resource utilization.
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