Key result
Povidone-iodine enemas combined with single-dose or 24-hour antibiotics reduced the rate of infected patients compared to saline enemas (8.5% vs 13%) in elective left colectomy.
Why the study?
Does single-dose ceftriaxone and ornidazole with povidone-iodine enemas prevent infective complications in patients undergoing elective left colectomy compared to 24-hour cefotaxime and metronidazole?
RCT (n=341)
Randomized to three groups
Does single-dose ceftriaxone and ornidazole with povidone-iodine enemas prevent infective complications in patients undergoing elective left colectomy compared to 24-hour cefotaxime and metronidazole?
Absolute Event Rate: 8.5% vs 13%
Single-dose ceftriaxone and ornidazole with povidone-iodine enemas is an effective and potentially cost-saving alternative to 24-hour antibiotic prophylaxis for preventing infective complications in elective left colonic surgery.
Supports povidone-iodine enemas with short-course antibiotics to lower infection rates in left colectomy; extends RCT evidence for adjunctive antisepsis.
Patients undergoing elective left colectomy for colonic carcinoma or diverticulosis (n = 341) were randomly assigned to three groups. Patients in groups 1 (102 patients) and 2 (122 patients) had two 5% povidone-iodine enemas whereas those in group 3 (117 patients) had saline enemas. Groups 1 and 3 received 24-hour intravenous cefotaxime sodium and metronidazole hydrochloride. Group 2 received single injections of ceftriaxone sodium (1 g) and ornidazole (1 g). Senna concentrate was administered the evening before surgery. There was no statistically significant difference found between groups 1 and 2 concerning the number of infected patients (eight vs 11), anastomotic leakages (four vs four), extra-abdominal complications (32 vs 29), or infection-related deaths (one vs zero). Despite poorer tolerance, povidone-iodine enema was more effective than saline enemas, as there were less infected patients in group 1 (8%) or groups 1 + 2 (8.5%) than in group 3 (13%). Single-dose ceftriaxone-ornidazole combined with povidone-iodine enemas is effective against infective complications in elective left colonic surgery for carcinoma or diverticular disease. Single-dose antibiotic prophylaxis reduces costs and work for the nursing staff.
No takes yet. Share an insight, caveat, or question.
Abe Fingerhut (1993) conducted an RCT in Colonic carcinoma or diverticulosis requiring elective left colectomy (n=341). Single-dose ceftriaxone, ornidazole, and povidone-iodine enema vs. 24-hour cefotaxime and metronidazole with povidone-iodine or saline enema was evaluated on Infected patients. Povidone-iodine enemas combined with single-dose or 24-hour antibiotics reduced the rate of infected patients compared to saline enemas (8.5% vs 13%) in elective left colectomy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: