Antimicrobial prophylaxis in upper gastrointestinal, biliary, stomach and oesophageal surgery

Start, duration and type of antimicrobial effect are decisive factor in prophylaxis in elective gastrointestinal surgery. Using a single dose regimen of 400 mg doxycycline and 1,600 mg tinidazole immediately prior to surgery a highly significant reduction of postoperative infectious complications was achieved in colorectal, gastric, small bowel and biliary surgery. Even after 10 years of regular use, no signs of clinical resistance have emerged with a wound infection rate of 1.2%. In Norway there is today no reason to introduce cephalosporins, penems or quinolones in prophylaxis of gastrointestinal surgery.