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.
Comparison of cefotaxime plus metronidazole versus cefoxitin for prevention of wound infection after abdominal surgery.
In a randomized prospective stratified trial consisting of 1010 patients undergoing abdominal surgery involving the viscera, the efficacy of cefotaxime plus metronidazole was compared to cefoxitin for preventing wound infection. The efficacy of a single dose of antibiotics versus three doses over 24 hours was also evaluated. This study demonstrated that a single-dose antibiotic regimen was as effective as a multiple-dose regimen in the prophylaxis of wound infections following abdominal surgery. In addition it demonstrated that the cefotaxime plus metronidazole regimen is comparable to that of cefoxitin and is more cost-effective. It is concluded that a single dose of cefotaxime plus metronidazole provides effective prophylaxis against postoperative wound infections following abdominal surgery.