Cefamandole preparation for colonic surgery

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Abstract
A controlled, prospective, randomized study of 457 patients undergoing colonic surgery was done to compare systemic cefamandole therapy to neomycin-erythromycin in reducing postoperative septic complications. Parenteral cefamandole and cephalothin were given before, during and after surgery to achieve maximal antimicrobial coverage in the blood, tissues, peritoneum and urine. Such protection is not obtained with oral antibiotic preparation. Major surgical indications were carcinoma in 216 patients with diverticulitis in 107 patients. More than half the patients had colonic perforations, obstruction or fistulas. All patients were operated upon by a single surgeon during 1975-1980. Cephalothin (151 patients), combined with neomycin-erythromycin, resulted in an 11.3% rate of postoperative septic complications. Cefamandole treatment in 112 patients resulted in an 8.9% postoperative infection rate compared with 16.3% in 141 matched control patients.