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.
Use of peroperative cefoxitin to prevent infection after colonic and rectal surgery.
A double-blind, controlled trial was performed to assess the effect of a short intraoperative course of Cefoxitin, a new broad spectrum cephamycin antibiotic, on the incidence of septic complications following elective colonic and rectal surgery. In addition to a two-day preoperative bowel preparation, patients entered in the study received a short course of either Cefoxitin (three 2g intravenous bolus doses at two-hour intervals, the first before skin incision) or a matching placebo. Thirty-two patients received Cefoxitin and 33 patients received the placebo. Postoperative abdominal wound infections developed in one (3%) of the Cefoxitin-treated patients and nine (27%) of the placebo-treated patients. This difference is statistically significant (p = 0.01). Septic complications remote from the abdominal wound, e.g. intra-abdominal abscesses, occurred in both Cefoxitin-treated and placebo-treated patients, but numbers were too small for meaningful analysis. The study shows that even a very short peroperative course of Cefoxitin is highly effective in reducing postoperative abdominal wound infections after elective colorectal surgery.