Authors' objectives:

This study aims to assess the effects of pre- and peri-operative antibiotic prophylaxis compared with no antibiotic on infection rates and mortality in patients undergoing colorectal surgery.

Authors' recommendations: We found no controlled studies published since Song and Glennys systematic review.5 The conclusions of the review about the efficacy of antibiotic prophylaxis therefore remain unchanged. The four studies included in the review1-4 consistently found that pre- and peri-operative antibiotics substantially reduced the risk of post-operative infection. The results support the reviews conclusions that antibiotic prophylaxis is effective in colorectal surgery and that the size of the reduction is clinically important. This conclusion is likely to apply to patients undergoing elective or emergency colorectal surgery, many of whom have malignant disease. The strength of the evidence for this conclusion is only moderate because of important methodological flaws within the trials reviewed. It is, however, unlikely that further trials will be carried out to provide stronger evidence. Further research is likely to focus on the cost-effectiveness of different antibiotic regimens and to help to shape policies to discourage inappropriate antibiotic use, including the provision of prophylaxis for longer than necessary.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.wihrd.soton.ac.uk

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: Wessex Institute for Health Research and Development

Contact Address: Pauline King. Wessex Institute for Health Research and Development, Boldrewood Medical School, Bassett Crescent East, Highfield, Southampton. SO16 7PX Tel. +44 1703 595661 Fax +44 1703 595662

Copyright: Bazian Ltd, Wessex Institute for Health Research and Development