Use of Peroperative CefoxitinR to Prevent Infection After Colonic and Rectal Surgery

Abstract

A double-blind, controlled trial was performed to assess the effect of a short intraoperative course of cefoxitin, a new broad spectrum cephamycin antibiotic, on the incidence of septic complications following elective colonic and rectal surgery. In addition to a 2-day preoperative bowel preparation, patients entered in the study received a short course of either Cefoxitin (three 2-g i.v. bolus doses at 2-h intervals, the first before skin incision) or a matching placebo. Thirty-two patients received cefoxitin and 33 patients received the placebo. Postoperative abdominal wound infections developed in 1 (3%) of the cefoxitin-treated patients and 9 (27%) of the placebo-treated patients. This difference is statistically significant (P = 0.01). Septic complications remote from the abdominal wound, e.g., intra-abdominal abscesses, occurred in cefoxitin-treated and placebo-treated patients, but numbers were too small for meaningful analysis. The study shows that even a very short peroperative course of cefoxitin is highly effective in reducing postoperative abdominal wound infections after elective colorectal surgery.