Elective colon surgery: clindamycin versus metronidazole prophylaxis

Orally administered clindamycin-neomycin as a prophylactic antibiotic in patients scheduled to undergo colon surgery was compared to orally administered metronidazole-neomycin. Clindamycin levels of the colon contents and the mucosa were 8 to 10 times higher than the serum levels. Three of the 43 patients who received metronidazole had wound infection whereas none of the 38 patients who received clindamycin did. Clindamycin may help to prevent staphylococcal infection, a known problem associated with metronidazole use. It may also play a role in preventing infection at the anastomosis in patients who undergo colon resection.