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Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1980 Apr;73(4):238–240. doi: 10.1177/014107688007300405

Importance of adding neomycin to metronidazole for bowel preparation1

S Vallance, Y Arabi, B Jones, M R B Keighley
PMCID: PMC1437403  PMID: 7017122

Abstract

A prospective randomized trial has investigated whether it is necessary to add oral neomycin to oral metronidazole as a means of preventing sepsis in elective colonic resection. Seventy-three patients completed the study; 41 received metronidazole and placebo neomycin and 32 received metronidazole and active neomycin. There was a significant reduction in the incidence of wound infection in patients receiving neomycin and metronidazole (22%) compared with metronidazole alone (51%, P<0.02). There was also a significant reduction in anaerobic infections in the group receiving metronidazole and neomycin compared with metronidazole alone (P<0.05). These results indicate that oral metronidazole alone is of no benefit for patients requiring elective colonic operations and that if oral metronidazole is advised it should always be given in combination with oral neomycin.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arabi Y., Dimock F., Burdon D. W., Alexander-Williams J., Keighley M. R. Influence of bowel preparation and antimicrobials on colonic microflora. Br J Surg. 1978 Aug;65(8):555–558. doi: 10.1002/bjs.1800650809. [DOI] [PubMed] [Google Scholar]
  2. Arabi Y., Dimock F., Burdon D. W., Alexander-Williams J., Keighley M. R. Influence of neomycin and metronidazole on colonic microflora of volunteers. J Antimicrob Chemother. 1979 Sep;5(5):531–537. doi: 10.1093/jac/5.5.531. [DOI] [PubMed] [Google Scholar]
  3. Clarke J. S., Condon R. E., Bartlett J. G., Gorbach S. L., Nichols R. L., Ochi S. Preoperative oral antibiotics reduce septic complications of colon operations: results of prospective, randomized, double-blind clinical study. Ann Surg. 1977 Sep;186(3):251–259. doi: 10.1097/00000658-197709000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Everett M. T., Brogan T. D., Nettleton J. The place of antibiotics in colonic surgery: a clinical study. Br J Surg. 1969 Sep;56(9):679–684. doi: 10.1002/bjs.1800560911. [DOI] [PubMed] [Google Scholar]
  5. Goldring J., McNaught W., Scott A., Gillespie G. Prophylactic oral antimicrobial agents in elective colonic surgery. A controlled trial. Lancet. 1975 Nov 22;2(7943):997–1000. doi: 10.1016/s0140-6736(75)90289-5. [DOI] [PubMed] [Google Scholar]
  6. Keighley M. R., Crapp A. R., Burdon D. W., Cooke W. T., Alexander-Williams J. Prophylaxis against anaerobic sepsis in bowel surgery. Br J Surg. 1976 Jul;63(7):538–541. doi: 10.1002/bjs.1800630711. [DOI] [PubMed] [Google Scholar]
  7. Leigh D. A. Wound infections due to Bacteroides fragilis following intestinal surgery. Br J Surg. 1975 May;62(5):375–378. doi: 10.1002/bjs.1800620512. [DOI] [PubMed] [Google Scholar]
  8. Matheson D. M., Arabi Y., Baxter-Smith D., Alexander-Williams J., Keighley M. R. Randomized multicentre trial of oral bowel preparation and antimicrobials for elective colorectal operations. Br J Surg. 1978 Sep;65(9):597–600. doi: 10.1002/bjs.1800650902. [DOI] [PubMed] [Google Scholar]
  9. Moore W. E., Cato E. P., Holdeman L. V. Anaerobic bacteria of the gastrointestinal flora and their occurrence in clinical infections. J Infect Dis. 1969 Jun;119(6):641–649. doi: 10.1093/infdis/119.6.641. [DOI] [PubMed] [Google Scholar]
  10. Nichols R. L., Condon R. E., Gorbach S. L., Nyhus L. M. Efficacy of preoperative antimicrobial preparation of the bowel. Ann Surg. 1972 Aug;176(2):227–232. doi: 10.1097/00000658-197208000-00019. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Taylor S. A., Cawdery H. M., Smith J. The use of metronidazole in the preparation of the bowel for surgery. Br J Surg. 1979 Mar;66(3):191–192. doi: 10.1002/bjs.1800660316. [DOI] [PubMed] [Google Scholar]
  12. Washington J. A., 2nd, Dearing W. H., Judd E. S., Elveback L. R. Effect of preoperative antibiotic regimen on development of infection after intestinal surgery: Prospective, randomized, double-blind study. Ann Surg. 1974 Oct;180(4):567–572. doi: 10.1097/00000658-197410000-00021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Willis A. T., Ferguson I. R., Jones P. H., Phillips K. D., Tearle P. V., Fiddian R. V., Graham D. F., Harland D. H., Hughes D. F., Knight D. Metronidazole in prevention and treatment of bacteroides infections in elective colonic surgery. Br Med J. 1977 Mar 5;1(6061):607–610. doi: 10.1136/bmj.1.6061.607. [DOI] [PMC free article] [PubMed] [Google Scholar]

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