The usefulness of
antibiotic prophylaxis in reducing the incidence of postoperative
infections following colorectal surgery has been defined in many clinical studies. Since a single
antibiotic agent covering all the potential pathogens (i.e. Gram-negative aerobes and anaerobes) is not currently available, a combination
therapy is usually administered. The present study reports the preliminary results on comparative efficacy and safety of
aztreonam and
gentamicin (both combined with
clindamycin) as short-term prophylaxis in colorectal surgery. Four hundred and fifty-four patients, out of 495 enrolled, were considered evaluable. Incidence of abdominal
wound infections was significantly lower in the
aztreonam-treated group (5.8% vs 12.596 - p ≤ .025). The incidence of perineal
wound and abdominal
infections, of
fever, of need for postoperative
antibiotics and the length of postoperative stay were lower in the
monobactam group, even if none of these differences were statistically significant. Gram-negative aerobic microorganisms were more often isolated in infected patients from the
gentamicin group. Side effects were minor and similar in the two groups. From these preliminary data, the
aztreonam-
clindamycin combination can be considered a major candidate to replace many of the presently available oral and parenteral regimens.