The influence of intra-incisional clindamycin on the incidence of wound sepsis after abdominal operations.

Two hundred and thirty consecutive patients undergoing laparotomy were randomly allocated to one of three single-dose intra-incisional prophylactic regimens: clindamycin, clindamycin plus cephaloridine, and cephaloridine alone. Wounds were classified on a bacteriological basis into four groups: clean, potentially contaminated, lightly contaminated and heavily contaminated. The first two of these groups had a low incidence of wound sepsis (6.6%), the third an incidence of 19.7% and the last of 53.1%. In the latter two groups clindamycin was a significantly less effective prophylactic than cephaloridine, and the combination of the two antibiotics was no more efficacious than cephaloridine alone. The high in vitro activity of cindamycin against Bacteroides species was not mirrored in vivo.