Efficacy of antibiotic prophylaxis in high risk gastroduodenal operations

A double-blind, prospective and randomized clinical trial of the efficacy of antibiotic prophylaxis in gastroduodenal operations was studied in 39 patients over an 18 month period. All patients had clinical features that placed them at high risk for the development of postoperative wound or intraabdominal sepsis. In the placebo group of 20 patients seven gastric-related infections developed, while 1 of the 19 patients who received perioperative cefamandole had one gastric-related infection (p less than 0.01). The responsible microorganisms were those that are normal components of the oral or intestinal microflora. Nongastric-related infections and deaths did not differ significantly in the two study groups. The results of this study confirm the efficacy of the use of short-term perioperative antibiotic prophylaxis in patients undergoing gastroduodenal surgery for bleeding duodenal or gastric ulcer, obstructing duodenal ulcer, gastric ulcer or malignancy.