Parenteral antibiotics in elective colon surgery? A prospective, controlled clinical study

The addition of perioperative gentamicin and clindamycin to an oral antibiotic bowel preparation was studied in a prospective, randomized, double-blind series of patients undergoing elective colectomy. Fifty-nine patients completed the study, with all receiving mechanical preparation of the colon and oral neomycin and erythromycin base. Thirty-one of these patients also received a preoperative and postoperative intravenous dose of gentamicin and clindamycin, while 28 received placebos. The two groups of patients were similar in age, both habitus, pathologic diagnosis, concomitant disease, operative procedures, operative time, blood loss, and adequacy of mechanical preparation of the colon. The incidence of infectious complications related to colectomy was 1% (three of 28) in the placebo group and 7% (two of 31) in the group receiving intravenous gentamicin and clindamycin. There were no wound infections directly related to colectomy in either group. There was no statistically significant reduction of infectious complications with the addition of intravenous gentamicin and clindamycin to oral neomycin and erythromycin-base bowel preparation.