Infectious problems in elective non-colorectal abdominal surgery. The Norwegian Gastro-Intestinal Group (NORGAS)

The incidence of post-operative infectious complications after high-risk biliary and gastroduodenal and all cases of small bowel surgery was investigated in 965 patients included in a prospective multi-centre study. Selected types of operation where antibiotic prophylaxis was considered beneficial were defined and patients in these categories were to receive a standardized prophylactic regimen of 400 mg doxycycline plus 1600 mg tinidazole intravenously 1-hour pre-operatively or at induction of anaesthesia. Of the 965 patients, 408 did not receive prophylaxis, 547 received the standard regimen and 10 were given a different prophylaxis. The overall compliance rate with the protocol was 89%. Analysis of the results of clinical evaluation of the patients 3, 7 and 15 days after surgery showed that only 21 (2.1%) of the 965 patients had developed surgical infectious complications. Two (0.2%) patients died of septic complications. No serious side-effects of the prophylactic regimen were recorded.