In France, addition of an oral antimicrobial dose reduced surgical site infections in people undergoing elective colorectal surgery, a study shows. The double-blind, placebo-controlled trial tested 1-g doses of ornidazole, a nitroimidazole antibiotic and antiprotozoal agents, administered 12 hours before surgery in 926 patients at 11 hospitals in 2016–19 (mean age, 63 years; 60% men). Participants also received intravenous antimicrobial prophylaxis before surgical incision.
“Surgical site infection within 30 days after surgery occurred in 60 of 463 patients (13%) in the oral prophylaxis group and 100 of 463 (22%) in the placebo group (absolute difference −8.6%, 95% confidence interval −13.5% to −3.8%; relative risk 0.60, 95% confidence interval 0.45 to 0.80),” the authors report. “The proportion of patients with deep infections was 4.8% in the oral prophylaxis group and 8.0% in the placebo group (absolute difference −3.2%, 95% confidence interval −6.4% to −0.1%). The proportion of patients with organ space infections was 5.0% in the oral prophylaxis group and 8.4% in the placebo group (absolute difference −3.4%, −6.7% to −0.2%). Major postoperative complications occurred in 9.1% patients in the oral prophylaxis group and 13.6% in the placebo group (absolute difference −4.5%, −8.6% to −0.5%).”