Ceftriaxone Single Dose versus Ceftazidime Multiple Doses in the Prophylaxis of Infection in Colorectal Surgery

Abstract

Sixty patients admitted to the hospital for colorectal surgery were randomly assigned to prophylaxis either with a single dose of ceftriaxone (Rocephin®) i.v. plus metronidazole given 30 min prior to induction of anesthesia or with multiple doses of ceftazidime plus metronidazole given repeatedly every 8 h up to 24 h after surgery. The overall number of infections observed with the long-acting cephalosporin ceftriaxone was 4 (2 local and 2 remote), with the short-acting ceftazidime the number was 9 (5 local and 4 remote). Neither regimen was associated with adverse reactions.

Antimicrobial prophylaxis in colorectal surgery: a systematic review of randomised controlled trials.

“…Ceftriaxone plus ornidazole was as efficacious as amikacin plus metronidazole. 147 Ceftriaxone plus metronidazole was as efficacious as ceftazidime plus metronidazole, 51 cefamandole plus metronidazole, 62 and co-amoxiclav, 113 and more efficacious than gentamicin plus metronidazole. 30 Two trials compared ceftriaxone plus metronidazole with oral neomycin plus erythromycin.…”

A Meta‐Analysis of Randomized, Controlled Trials Assessing the Prophylactic Use of Ceftriaxone. A Study of Wound, Chest, and Urinary Infections

“…1. After triage, there were 90 remaining studies that were included in the meta‐analysis [6–9, 12–96]. Of these 44 were sourced from Medline, an additional 8 from Embase, 10 from the Cochrane registers, 10 from scientific meetings, and 18 from identified references.…”

“…The comparison between ceftriaxone and other antibiotics in reducing SSI was analyzed in 64 studies ( n = 22,888 patients) [6–9, 12–70]. The funnel plot identified three studies that were on or outside the 95% confidence interval, all in favor of ceftriaxone, which were excluded from further analysis [44, 61, 64].…”

“…The comparison between ceftriaxone and other antibiotics in reducing urinary tract infections was analyzed in 44 studies ( n = 14,907 patients) [6–9, 13, 15, 17, 20, 23–27, 30, 36, 37, 39, 41, 43, 46–51, 55, 57, 62, 63, 65, 67–69, 71–82]. The funnel plot identified three studies [49, 74, 78] that were on or outside the 95% confidence interval, two [74 78] in favor of ceftriaxone.…”

Worldwide Clinical Experience with Ceftriaxone

“…in cardio vascular surgery [Recker et al, 1987]; bil iary surgery [De la Hunt et al, 1985]; ab dominal surgery [Cucchiaro et al, 1987;Kracht, 1988, fig. 7; Morris, 1988]; colo rectal surgery [Garcia et al, 1988]; hyster ectomy [Harms and Schumacher, 1986;Decavalas et al, 1988, fig. 8]; orthopedic surgery [Periti, 1988, fig.…”