• Keiichiro Ishibashi, Kouki Kuwabara, Toru Ishiguro, Tomonori Ohsawa, Norimichi Okada, Tatsuya Miyazaki, Masaru Yokoyama, and Hideyuki Ishida.
• Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981 Tsujido-machi, Kamoda, Kawagoe, Saitama, 350-8550, Japan.
• Surg. Today. 2009 Jan 1;39(12):1032-9.

PurposeWe performed a prospective randomized study to assess the effectiveness of short-term intravenous antimicrobial prophylaxis in combination with preoperative oral antibiotics on a surgical site and methicillin-resistant Staphylococcus aureus (MRSA) infection in elective colon cancer surgery.MethodsThe patients were administered preoperative oral antibiotics, kanamycin and erythromycin, after mechanical cleansing, which began within 24 h of elective surgery for colon cancer. The patients were randomly assigned to receive the intravenous administration of cefmetazol or cefotiam on the day of surgery (group 1) or for 3 days (group 2). A total of 275 patients (136 for group 1 and 139 for group 2) were eligible for the study.ResultsThe incidence of a surgical site infection was 5.1% in group 1 and 6.5% in group 2 (P = 0.80). The incidence of MRSA infection was 2.2% in group 1 and 2.9% in group 2 (P > 0.99). A multivariate logistic regression analysis showed that the American Society of Anesthesiologists physical status score and the duration of surgery were independent significant factors affecting the surgical site infection and MRSA infection.ConclusionThese findings suggest that short-term intravenous antimicrobial prophylaxis in combination with preoperative oral antibiotics may be successfully applied to colon cancer surgery that is generally performed in Japan.

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