Single versus triple dose antimicrobial prophylaxis in elective abdominal surgery and the impact on bacterial ecology

The results of 28 months of surveillance of postoperative wound infection rates in elective abdominal surgery using triple or single dose antimicrobial prophylaxis are reported. No significant differences in infection rates were seen in 217 patients undergoing gastric, biliary and pancreatic surgery who received either triple or single dose cefuroxime. Also, no significant differences in infection rates were seen in 198 patients undergoing jejunal, ileal and colorectal surgery who received either triple or single dose cefuroxime plus metronidazole. Our findings are consistent with those of other studies and support the conclusion that single dose prophylaxis is as effective as triple dose in elective abdominal surgery. During the study period there was no change in the pattern of bacteria isolated or in cefuroxime resistance rates from infected sites of patients from the Department of Surgery. No increased rate of cefuroxime resistance was seen in urinary isolates from patients elsewhere in the hospital.