***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In a prospect i ve , r and omized , comparative study , patients undergoing elective major colorectal surgery received four six-hour doses of either sulbactam ( a β-lactamase inhibitor ) with ampicillin ( 1 gm with 1 gm ) , or cefoxitin ( 2 gm ) commencing at induction of anesthesia . The groups were well matched for age , sex , diagnosis , and surgical procedures . Three patients in the sulbactam group ( N=44 ) , and four in the cefoxitin group ( N=48 ) developed significant would sepsis . Minor wound sepsis occurred in an additional four sulbactam patients , and in five cefoxitin patients . There was no difference between the groups in deep sepsis or anastomotic leak rates ( sulbactam , four patients ; cefoxitin , seven patients ) . No serious side effects were recorded in either group . These results suggest that sulbactam combined with ampicillin provides a safe , effective alternative to cefoxitin for prophylaxis in colorectal surgery Although perioperative antibiotic cover reduces the incidence of septic complications associated with abdominal surgery , the optimum duration of antibiotic exposure is open to question . This clinical trial compared the efficacy of a single dose of moxalactam ( 1 g intravenously ) with an extended course of moxalactam ( 1 g intravenously for eight doses ) in 1027 patients undergoing contaminated abdominal surgery . The wound infection rate was 5.4 % ( 28/519 ) for the single-dose schedule and 6.1 % ( 31/508 ) for the extended-cover regimen ( the respective 95 % confidence intervals being 3.6 % to 7.7 % and 4.2 % to 8.6 % ) . Over 80 % of all patients undergoing abdominal surgery during the period of study were entered into the trial . There was no significant difference in the incidence of other complications between the two groups under study . It is concluded that a single dose of moxalactam is as effective as a 48-hour course when attempting to prevent infection after contaminated abdominal surgery A r and omized trial including 294 patients was performed to evaluate the prophylactic effect of singlevs . multiple doses of antibiotics in elective colorectal surgery . All patients received 1.5 g metronidazole and 3.0 g ampicillin peroperatively and were r and omized to : 1 ) no further prophylactic antibiotic treatment , or 2 ) ampicillin 1 g × 3 and metronidazole 0.5 g × 3 given intravenously during the second and third postoperative days . Deep wound infection was seen in 9/149 ( 6 percent ) receiving a single dose and in 8/145 ( 6 percent ) receiving multiple doses . no differences were found in the two groups between frequencies of anastomotic dehiscences , intra-abdominal abscesses , sepsis , and pulmonary infections . the two groups were similar according to distribution of sex , age , diagnosis , and type of surgery . A single peroperative dose of metronidazole and ampicillin is a simple and satisfactory antibiotic prophylaxis in elective colorectal surgery Summary Due to the high incidence of infective complications following colorectal surgery , prophylactic application of systemic antibiotics is required . In a prospect i ve , r and omised study of 34 patients who underwent elective colorectal surgery , it was found that a single 1 g dose of cefotaxime was as effective as three doses in controlling post-operative infections . Both groups received 500 mg metronidazole i.v . every 12 h for 72 h , with the first dose administered immediately prior to surgery . The results indicate that prophylactic cefotaxime and metronidazole are effective in reducing the incidence of septic complications following colorectal surgery ; nevertheless , a study with a larger number of patients is needed to reach a definitive conclusion .ZusammenfassungKolorektale Operationen sind durch eine hohe Inzidenz an infektiösen Komplikationen belastet ; eine systemische Antibiotikaprophylaxe ist daher erforderlich . In einer prospektiven , r and omisierten Studie wurden zwei Cefotaxim-Prophylaxeregime — die i.v . Gabe einer Einzeldosis von 1 g Cefotaxim bei gleichzeitiger Injektion von 500 mg Metronidazol kurz vor Beginn der Operation — und drei Einzelgaben von 1 g Cefotaxim — verglichen . In beiden Fällen wurde Metronidazol mit der ersten Dosis gegeben und in 12-stündlichen Abständen bis 72 Stunden postoperativ wiederholt . Die noch nicht abgeschlossene Studie umfaßt bisher 34 Patienten , bei denen ein elektiver kolorektaler Eingriff vorgenommen wurde . Das Prophylaxeregime mit Cefotaxim und Metronidazol erwies sich — sowohl bei der Einzel- wie der Dreifach-Dosierung von Cefotaxim — als wirksame Method e , infektiöse Komplikationen bei kolorektalen Eingriffen zu verhüten . Ein abschließendes Urteil ist erst mit einer umfangreichen Patientenzahl möglich To assess the suitability of latamoxef ( moxalactam ) as single agent chemoprophylaxis in elective colorectal surgery , 120 consecutive patients were r and omized to receive latamoxef ( L ) 1 g or cephazolin 1 g and metronidazole 500 mg ( CM ) administered intravenously at induction of anaesthesia and 6 and 12 h postoperatively . The groups were well matched for age , sex , pathology and procedures . Serum and tissue levels of latamoxef  were well above the MIC90 for most bowel organisms . Inpatient stay was similar for both groups . Pyrexia was seen in 44 patients ( 11 L , 23 CM ) and eight developed a wound infection ( 3 L , 5 CM ) . Major intra-abdominal sepsis occurred in seven patients ( 2 L , 5 CM ) , secondary to anastomotic leakage in four ( 1 L , 3 CM ) . Twenty patients developed a chest infection ( 5 L , 15 CM ) and eight urinary sepsis ( 2 L , 6 CM ) . No bleeding complication occurred , and there was no difference in clotting function between the two groups . Six patients died prior to follow-up at six weeks ( 1 L , 5 CM ) , two from anastomotic dehiscence . All but three wounds had healed ( 1 L , 2 CM ) and one further patient had an incisional hernia ( CM ) . These results suggest that latamoxef is an efficient chemoprophylactic agent in elective colorectal surgery , and is marginally better than cephazolin plus metronidazole A prospect i ve , r and omized , controlled trial was conducted in 116 consecutive patients undergoing colorectal surgery to compare single dose prophylaxis with mezlocillin to cefuroxime plus metronidazole in three doses . Patients were r and omized to receive either a single dose of iv mezlocillin ( 5.0 g ) or three doses of iv cefuroxime plus metronidazole at 8-hourly intervals . The first dose was given on the operating table . The overall wound infection rate in the mezlocillin treated patients ( n = 54 ) was 30 % and in the patients treated with cefuroxime plus metronidazole ( n = 56 ) 25 % . This difference is not statistically significant . When trivial wound infections were disregarded the wound infection rates were 11 % and 16 % respectively , which again was not statistically significant A r and omized prospect i ve study was conducted on 194 patients who underwent elective colorectal surgery for carcinoma . All patients received the same mechanical bowel preparation . In addition , patients in group A received oral neomycin and erythromycin base ; patients in group B received systemic metronidazole and gentamicin , while patients in group C received both oral and systemic antibiotics .  Postoperative septic complications related to colorectal surgery occurred in 27.4 per cent , 11.9 per cent and 12.3 per cent respectively in groups A , B and C ( X2 = 7 ; P < 0.05 ) . The incidence of sepsis in groups B and C was almost identical . Patients who received oral antibiotics alone ( group A ) had significantly higher risks of postoperative sepsis when compared with patients in either group B or group C ( P < 0.05 ) . As there is no additional advantage of combining oral and systemic antibiotics , we recommend systemic metronidazole and gentamicin to be used with mechanical bowel preparation in elective colorectal surgery One hundred patients undergoing colorectal operations were r and omly assigned to a parenteral prophylactic regimen with 2 g cefotaxime i.v . ( 3 doses ) or to our present oral prophylaxis with neomycin-erythromycin .  Wound infection occurred in 2 patients who received cefotaxime ( 4 % ) compared with 6 patients ( 12 % ) who received neomycin-erythromycin , a nonsignificant difference . Nor was there any significant difference between the anastomotic leakage rates , 12.5 % and 6.1 % . Predominant pathogens wereEscherichia coli and Bacteroides fragilis . The results show that a 12-hour cover with cefotaxime has a low rate of infectious complications and is as effective a prophylaxis as neomycin-erythromycin orally . RésuméCent malades destinés à subir des opérations colo-rectales ont fait l'objet d'une étude r and omisée comparative permettant d'apprécier l'action prophylactique de la cefotaxime ( 2 g par voie intra-veineuse en 3 doses ) ou de la néomycineerythromycine par voie orale . Une infection pariétale s'est manifestée chez 2 malades qui recevaient de la cefotaxime ( 4 % ) et chez 6 malades ( 12 % ) qui étaient préparés par le traitement prophylactique classique mais la différence n'est pas significative . Il en est de même en ce qui concerne le taux de fistulisation de l'anastomose respectivement 12.5 % et 6.1 % . Les agents pathogènes en cause furent l'Escherichia coli et leBactéroides fragilis . Les résultats de cette étude montrèrent qu'une couverture pendant 12 heures par de la cefotaxime coïncide avec un faible taux de complications infectieuses et que ce traitement antibiotique prophylactique est aussi efficace que le traitement classique comportant l'ingestion de néomycineerythromycine . ResumenCien pacientes programados para operaciones colorrectales fueron asignados en forma aleatorizada a un regimen de profilaxis parenteral a base de 2 g de cefotaxime i.v . ( 3 dosis ) o a nuestro regimen actual de profilaxis oral con neomicinaeritromicina . Se presentó infección de la herida en 2 pacientes que recibieron cefotaxime  ( 4 % ) en comparación con 6 pacientes ( 12 % ) que recibieron neomicina-eritromicina  , lo cual es una diferencia no significativa ; no hubo diferencia significativa entre las tasas de escape anastomótico , 12.5 % y 6.1 % . Los organismos patógenos predominantes fueronEscherichia coli yBacteroides fragilis . Los result ados indican que la cobertura de 12 horas con cefotaxime se acompaña de una baja tasa de complicaciones infecciosas y representa una forma tan efectiva de profilaxis como la neomicina-eritromicina por vía oral In the last 2 years , 50 patients who underwent elective colorectal surgery were prospect ively studied about antibiotic prophylaxis . Two groups of 25 patients each were r and omly selected . Both received : ( a ) a colic preparation : hypactic drugs and two enemas during the day before surgery and ( b ) metronidazole 0.5 g plus neomycin 1 g per 8 h orally for 1 day before surgery . Every group also received : group A , metronidazole 0.5 g plus amikacin 500 mg i.v . 2 h before surgery and the same doses per 8 or 12 h , respectively , for 2 days postoperatively ; group B , ornidazole 1 g by intravenous infusion plus ceftriaxone 2 g i.v . 2 h before surgery and the same doses of the drugs per 24 h for 2 days postoperatively . Wound infection occurred in 1 case of group A versus 2 cases of group B ( p greater than 0.25 ) .  Ornidazole plus ceftriaxone prophylactic antibiotic therapy  is therefore as effective as a classic therapy  ( metronidazole plus amikacin ) and constitutes an alternative choice for patients undergoing elective colorectal surgery , because the simple manner of its administration ( once per 24 h ) is result ing in cost saving due to gained nursing time Antibiotics used for prophylaxis in elective colorectal surgery should be effective against the organisms contaminating the soft tissues and isolated from postoperative infections . These are usually the enterobacteriaceae commens 
    Output:
    
The results confirm that the use of antimicrobial prophylaxis is effective for the prevention of  surgical wound infection after colorectal surgery .
There was no significant difference in the rate of surgical wound infections between many different regimens .
However , certain regimens appear to be inadequate ( e.g. metronidazole alone , doxycycline alone , piperacillin alone , oral neomycin plus erythromycin on the day before operation ) .