Prophylactic co-trimoxazole in biliary surgery.

A double-blind study was conducted to test the prophylactic effect of a single dose of co-trimoxazole on the incidence of septic complications after elective cholecystectomy. Forty-eight patients received co-trimoxazole and 47 placebo. Wound sepsis occurred in 10 (21%) of the controls but in only 2 (4%) of the treated group, and the incidences of pulmonary complications were 49% (23 cases) and 19% (9) respectively. These differences were significnat. Wound sepsis after cholecystectomy occurs mostly in patients with infected bile. Co-trimoxazole given by intravenous infusion rapidly achieves a high concentration in the palsma and is effective against most biliary pathogens.