Ceftizoxime Alone or in Combination with Metronidazole as Prophylaxis in Elective Colorectal Surgery

In a prospective double-blind randomised trial, 200 patients undergoing elective colorectal surgery received ceftizoxime 2g with either placebo or a single dose of metronidazole 500mg followed by a single dose of ceftizoxime 2g two hours later in both treatment groups. There was no difference in the rate of wound infection (9 of 85 vs 7 of 89), distal site infection (16 of 85 vs 18 of 89) or noninfective complications between the 2 treatment groups. Duration of hospital stay was also similar for the 2 groups (mean 11.3 vs 12.3 days). The low incidence of wound infection in this study is particularly impressive, as 13 of 16 wound infections were delayed, minor superficial discharges occurring after the patient left hospital. These results suggest that intravenous ceftizoxime offers effective prophylaxis in colorectal surgery and may be used without metronidazole.