Short-term antibiotic prophylaxis in elective colorectal surgery

Area of Science:

• Surgical Infectious Diseases
• Pharmacology
• Colorectal Surgery

Background:

• Antibiotic prophylaxis is crucial for preventing surgical site infections (SSIs) in elective colorectal surgery.
• Optimizing antibiotic regimens can improve patient outcomes and reduce healthcare costs.
• Evaluating novel antibiotic combinations for efficacy and cost-effectiveness is essential.

Purpose of the Study:

• To compare the efficacy of ornidazole plus ceftriaxone with metronidazole plus amikacin for antibiotic prophylaxis in elective colorectal surgery.
• To assess the incidence of wound infections between the two prophylactic antibiotic groups.
• To determine the cost-effectiveness of the novel regimen based on administration frequency.

Main Methods:

• Prospective study of 50 patients undergoing elective colorectal surgery, randomized into two groups (n=25 each).
• Both groups received bowel preparation and oral metronidazole/neomycin preoperatively.
• Group A received intravenous metronidazole plus amikacin; Group B received intravenous ornidazole plus ceftriaxone, with specific dosing regimens for 2 days postoperatively.

Main Results:

• Wound infection occurred in 1 patient in Group A and 2 patients in Group B (p > 0.25), indicating comparable efficacy.
• The ornidazole plus ceftriaxone regimen demonstrated non-inferiority to the metronidazole plus amikacin regimen.
• The simplified 24-hour administration of ornidazole plus ceftriaxone offers potential cost savings.

Conclusions:

• Ornidazole plus ceftriaxone is a viable and effective prophylactic antibiotic alternative for elective colorectal surgery.
• The simpler administration schedule of the novel regimen can lead to significant cost savings.
• This alternative regimen provides comparable efficacy to standard therapy with added economic benefits.