Peroperative cefuroxime v. long-term ampicillin and metronidazole in high-risk biliary and gastric surgery. A multicentre trial.

Randomization to cefuroxime in a two-dose peroperative regimen or to combined peroperative and postoperative (4 days) ampicillin and metronidazole was performed in a series of 418 high-risk patients undergoing biliary or gastric surgery. Postoperative wound infection appeared in 9 of the 210 patients who received ampicillin and metronidazole and in 2 of the 208 given cefuroxime (p less than 0.05). Four intraabdominal abscesses occurred in the former group and one in the latter. Three of these abscesses probably were attributable to complications of surgery as such, leaving one intraabdominal abscess in each group. Peroperative cefuroxime is concluded to be more effective than longer administration of ampicillin/metronidazole as protection against wound infection in high-risk patients undergoing biliary or gastric surgery.