Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan.
Surg Today. 2010 Oct;40(10):954-7. doi: 10.1007/s00595-009-4176-5. Epub 2010 Sep 25.
Postoperative antimicrobial therapy is generally administered as standard prophylaxis against postoperative infection, despite a lack of sufficient evidence for its usefulness. This study was a phase II study to evaluate the necessity of postoperative antibiotic prophylaxis in patients undergoing a colectomy.
Patients received 1 g cefmetazole or flomoxef immediately after anesthetic induction, every 3 h during surgery, and then later once again on the next day. They were randomly assigned to receive either cefmetazole or flomoxef.
Ninety-one patients were enrolled in the study. A surgical site infection (SSI) occurred in 7.7% (7/91) of patients. All cases were superficial incisional infections. When comparing the two drugs, SSI occurred in 8.3% (4/48) of patients treated with cefmetazole and in 7.0% (3/43) treated with flomoxef, showing no significant difference (P > 0.99).
Antimicrobial prophylaxis was well tolerated when used on the day of a colectomy and once again on the next day.
尽管缺乏充分的有效性证据，术后抗菌治疗仍被普遍作为预防术后感染的标准方案。本研究为 II 期研究，旨在评估结直肠切除术后患者使用抗生素预防术后感染的必要性。
患者在麻醉诱导后立即接受 1g 头孢美唑或头孢呋辛治疗，术中每 3 小时给药一次，术后次日再给药一次。患者被随机分为头孢美唑组或头孢呋辛组。
本研究共纳入 91 例患者。7 例（7/91）患者发生手术部位感染（SSI），均为表浅切口感染。比较两种药物时，头孢美唑组 SSI 发生率为 8.3%（4/48），头孢呋辛组为 7.0%（3/43），两组间无显著差异（P＞0.99）。
在结直肠切除术后当天及次日使用抗菌药物预防治疗具有良好的耐受性。
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