Metronidazole prophylaxis in colorectal surgery: the need for additional aminoglycoside?

A randomized double-blind trial was conducted in two phases to compare the efficacy of prophylactic oral and intravenous administration of kanamycin and metronidazole in preventing wound infection and other complications in patients undergoing colorectal surgery, and also to assess the need for inclusion of an aminoglycoside in the prophylactic regimen. Adequate prophylaxis did not depend on the route of antimicrobial administration, but wound infection rates were increased following exclusion of kanamycin.