Antibiotics covering aerobic and aerobic bacteria should be delivered orally and intravenously prior to colorectal surgery.  Antibiotics delivered within this framework will reduce the risk of postoperative SWI by at least 75%.  Further research is required to establish the optimal timing and duration of dosing, and frequency of longer-term adverse effects such as Clostridium difficile pseudomembranous colitis.
A prospective comparison of gentamicin and metronidazole and moxalactam in the prevention of septic complications associated with elective operations of the colon and rectum.
Bacteriologic evidence suggests that Latamoxef (moxalactam) is effective against colonic bacteria which cause infection during colonic and rectal operations. In a prospective comparative study, 86 patients undergoing colorectal operations were randomized to receive intravenously 24 hour antibiotic cover with either gentamicin and metronidazole or moxalactam. Six patients (13 per cent) in the gentamicin and metronidazole group and five (12 per cent) in the moxalactam group had wound sepsis develop. Perineal wound sepsis (31 per cent) was significantly more common than abdominal wound sepsis (7 per cent). No complications were noted from the use of moxalactam. No clinical evidence of abnormal bleeding was seen and the results of studies on coagulation and platelet function postoperatively were normal. The results suggest that moxalactam provides effective, safe prophylaxis comparable with established antibiotic combinations in patients undergoing colorectal operations.