A comparison of aztreonam/metronidazole and cefotaxime/metronidazole in elective colorectal surgery: antimicrobial prophylaxis must include Gram-positive cover

Abstract
Aztreonam/metronidazole and cefotaxime/metronidazole were compared in a prospective trial in 154 patients undergoing elective colorectal surgery. Three antibiotic doses were given over 16 hours. A significant excess of wound sepsis in the aztreonam group was seen (23/71 vs 9/70 ξ2 6·60; P < 0.01). Sepsis was almost invariably due to Gram-positive organisms and, in particular, Staphylococcus aureus.