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[Single preoperative dose of metronidazole plus gentamicin for antimicrobial prophylaxis in colorectal surgery]

José Manuel Ventura Cerdá1, Jesús Nomdedeu Guinot, Manuel Alós Almiñana

  • 1Servicio de Farmacia, Hospital General de Castellón, Avenida Benicasim s/n, 12004 Castellón, Spain. ventura_jma@gva.es

Medicina Clinica
|August 1, 2007
PubMed
Abstract

Insights

A single preoperative dose (SD) of metronidazole and gentamicin is as effective as a multiple-dose (MD) regimen for colorectal surgery. This antibiotic strategy significantly reduces hospital stay and costs without compromising patient outcomes.

Area of Science:

  • Surgical Oncology
  • Infectious Disease
  • Pharmacoeconomics

Context:

  • Elective colorectal surgery necessitates effective antibiotic prophylaxis to prevent surgical site infections.
  • Current perioperative antibiotic protocols often involve multiple doses, increasing complexity and cost.
  • Optimizing antibiotic regimens is crucial for improving patient outcomes and reducing healthcare expenditures.

Purpose:

  • To compare the clinical effectiveness and economic impact of a single preoperative dose (SD) versus a multiple-dose (MD) perioperative antibiotic schedule.
  • To evaluate if SD of metronidazole and gentamicin offers equivalent efficacy to MD in reducing surgical-related infections and length of stay.
  • To determine the cost-effectiveness of SD antibiotic prophylaxis in elective colorectal surgery.

Summary:

  • A retrospective cohort study compared 978 patients receiving a single preoperative dose (SD) of metronidazole and gentamicin with 414 patients receiving a multiple-dose (MD) regimen for elective colorectal surgery.
  • The SD group experienced a significant reduction in mean length of stay (14.0 days) compared to the MD group (17.5 days) (p < 0.001).
  • No significant differences were observed in mortality rates (3.2% overall) or surgical infection rates (8.6% overall) between the SD and MD cohorts. The SD regimen resulted in a 35% cost reduction per procedure.

Impact:

  • The single preoperative dose (SD) antibiotic strategy is clinically equivalent to multiple doses (MD) for elective colorectal surgery.
  • Implementing SD antibiotic prophylaxis can lead to substantial reductions in patient length of stay and direct healthcare costs.
  • This finding supports the adoption of SD antibiotic regimens as a more efficient and cost-effective approach in surgical prophylaxis.

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