Cefotetan versus Conventional Triple Antibiotic Prophylaxis in Elective Colorectal Cancer Surgery

Abstract

This study examined infectious outcomes in elective colorectal cancer surgery between cefotetan alone or conventional triple antibiotics. From January to December 2007, 461 consecutive primary colorectal cancer patients underwent elective surgery. Group A contained 225 patients who received conventional triple antibiotics (cephalosporin, aminoglycoside and metronidazole) for prophylaxis, and group B contained 236 patients who received cefotetan alone for prophylaxis. Treatment failure was defined as the presence of postoperative infection including surgical-site infection (SSI), anastomotic leakage, and pneumonia or urinary tract infection. The two groups were similar in terms of demographics, American Society of Anesthesiologists (ASA) score, tumour location, stage, surgical approach (conventional open vs. laparoscopy-assisted), and type of operation. The treatment failure rates were 3.1% in Group A and 3.4% in Group B (absolute difference, -0.3%; 95% confidence interval [CI], 0.39 to 3.07, P=0.866), with SSI being the most common reason for failure in both groups (2.7% in Group A and 3.0% in Group B [absolute difference, -0.3%; 95% CI, 0.37 to 3.37, P=0.846]). Cefotetan alone is as effective as triple antibiotics for prophylaxis in primary colorectal cancer patients undergoing elective surgery.

Early Outcomes of Endoscopic Submucosal Dissection for Colorectal Neoplasms According to Clinical Indications

“…the prophylactic administration of antibiotics is known to be useful in the prevention of wound infection, and broad-spectrum antibiotics are recommended immediately before colorectal surgery. 26,27 in the field of therapeutic endoscopy of the colon, this practice is still controversial. further efforts are needed to provide practice standards and guidelines for colorectal esD.…”

Mechanical Bowel Preparation and Prophylactic Antibiotic Administration in Colorectal Surgery: A Survey of the Current Status in Korea

“…About one-third of the colorectal specialists use their own prescriptions, such as third-generation cephalosporin and fluoroquinolone treatment. A recently published study by Jeong et al [26] reported that second-generation cephalosporin alone was as effective as a triple regimen composed of first-generation cephalosporin, metronidazole, and aminoglycoside for elective colorectal cancer surgery prophylaxis.…”

Pharmacokinetic differences between the epimers of cefotetan disodium after single intravenous injection in healthy Chinese volunteers

“…Cefotetan (CTT) disodium is a third-generation semisynthetic cephamycin antibiotic with a broad-spectrum of antibacterial activity and a favorable pharmacokinetic activity (Ward and Richards 1985). A long serum half-life and resistance to beta-lactamase hydrolysis have made cefotetan an attractive chemotherapeutic agent, and the results of clinical trials worldwide have demonstrated its efficacy in a wide variety of clinical situations (Martin et al 1994), especially used as a prophylaxis in abdominal and pelvic surgeries (de Lalla 2009;Mahmoud et al 2009;Jeong et al 2010). The National Surgical Infection Prevention Project (NSIPP) has recommended prophylactic cefotetan administration to prevent infections in colorectal surgery patients, and cefotetan is currently the most commonly prescribed prophylactic antimicrobial agent in the United States (Bratzler et al 2005).…”