A prospective, randomized, double-blind study of 10% mannitol mechanical bowel preparation combined with oral neomycin and short-term, perioperative, intravenous Flagyl as prophylaxis in elective colorectal resections.

The effect of 1-day mechanical bowel preparation with 10% mannitol combined with oral neomycin and short-term perioperative intravenous Flagyl (group I) was studied in a prospective, randomized, double-blind study and was compared with oral neomycin and an intravenous placebo (Group II). Thirty-one patients were evaluated in group I (Flagyl), and there was a 0% septic complication rate. Thirty-seven patients were in the neomycin placebo group (group II), which had a septic complication rate of 22%. The difference between the two groups was statistically significant. No complications were observed from either the 10% mannitol solution or the intravenous Flagyl at either clinical, hematologic, or biochemical assessment. The study indicates that 1-day mechanical bowel preparation with 10% mannitol combined with oral neomycin and short-term, perioperative, intravenous Flagyl is a safe, effective, and inexpensive method for significantly reducing the septic complications of elective colorectal surgical resections.