Parenteral Antibiotics Compared to Combination of Oral and Parenteral Antibiotics in Colorectal Surgery Prophylaxis

NCT ID: NCT02505581

Last Updated: 2020-01-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

536 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-05-31

Study Completion Date

2018-11-10

Brief Summary

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Routine antibiotics for the intravenous and oral prophylaxis of colorectal surgery will be used.

Experimental group: Patients undergoing elective colorectal surgery that involves, colonic resection.

The antibiotic prophylaxis in this group will be composed of:

An oral antibiotic pattern of ciprofloxacin (750mg / 12h, 2 doses) and metronidazole (250mg / 8h, 3 doses) the day before surgery.

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Control group: Patients undergoing elective colorectal surgery that involves, colonic resection.

The antibiotic prophylaxis in this group will be composed of:

An intravenous antibiotic pattern of cefuroxime 1g and metronidazole 1,5gr during anesthetic induction.

In both groups a second intravenous dose of cefuroxime (750mg) will be administered if the intraoperative time elongates more than three hours or there is an intraoperative bleeding over 1000cc.

There won´t be a placebo treatment. Subject compliance will be evaluated according to the usual practice in surgical care field

Detailed Description

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Conditions

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Surgical Wound Infection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Oral + Parenteral prophylaxis

Group Type EXPERIMENTAL

Extra dosage - cefuroxime (750mg) I.V

Intervention Type DRUG

In both groups a second intravenous dose of cefuroxime (750mg) will be administered if the intraoperative time elongates more than three hours or there is an intraoperative bleeding over 1000cc

Colorectal Surgery

Intervention Type PROCEDURE

Both groups undergo colorectal surgery. This section does not include rectal surgery ( see Inclusion/exclusion criteria)

Ciprofloxacin 750 mg oral

Intervention Type DRUG

An oral antibiotic pattern of ciprofloxacin (750 mg / 12h, 2 doses) the day before surgery.

Metronidazole 250 mg oral

Intervention Type DRUG

An oral antibiotic pattern of metronidazole (250 / 8h, 3 doses) the day before surgery.

Cefuroxime 1.5 g Intravenous

Intervention Type DRUG

An intravenous antibiotic pattern of cefuroxime 1.5 g during anesthetic induction.

Metronidazole 1 g Intravenous

Intervention Type DRUG

An intravenous antibiotic pattern of metronidazole 1 g during anesthetic induction.

Only Parenteral prophylaxis

Group Type ACTIVE_COMPARATOR

Extra dosage - cefuroxime (750mg) I.V

Intervention Type DRUG

In both groups a second intravenous dose of cefuroxime (750mg) will be administered if the intraoperative time elongates more than three hours or there is an intraoperative bleeding over 1000cc

Colorectal Surgery

Intervention Type PROCEDURE

Both groups undergo colorectal surgery. This section does not include rectal surgery ( see Inclusion/exclusion criteria)

Cefuroxime 1.5 g Intravenous

Intervention Type DRUG

An intravenous antibiotic pattern of cefuroxime 1.5 g during anesthetic induction.

Metronidazole 1 g Intravenous

Intervention Type DRUG

An intravenous antibiotic pattern of metronidazole 1 g during anesthetic induction.

Interventions

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Extra dosage - cefuroxime (750mg) I.V

In both groups a second intravenous dose of cefuroxime (750mg) will be administered if the intraoperative time elongates more than three hours or there is an intraoperative bleeding over 1000cc

Intervention Type DRUG

Colorectal Surgery

Both groups undergo colorectal surgery. This section does not include rectal surgery ( see Inclusion/exclusion criteria)

Intervention Type PROCEDURE

Ciprofloxacin 750 mg oral

An oral antibiotic pattern of ciprofloxacin (750 mg / 12h, 2 doses) the day before surgery.

Intervention Type DRUG

Metronidazole 250 mg oral

An oral antibiotic pattern of metronidazole (250 / 8h, 3 doses) the day before surgery.

Intervention Type DRUG

Cefuroxime 1.5 g Intravenous

An intravenous antibiotic pattern of cefuroxime 1.5 g during anesthetic induction.

Intervention Type DRUG

Metronidazole 1 g Intravenous

An intravenous antibiotic pattern of metronidazole 1 g during anesthetic induction.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients presenting colonic pathology
* The surgery is not contraindicated
* Diagnosis of colorectal neoplasia or diverticular disease with surgical indication (stenosis, chronic constipation, recurrent infections etc ..)
* Indication of segmentary resection or total colectomy
* Patients who agree to participate voluntarily in the study and signed an informed consent.

Exclusion Criteria

* Patients who refuse to participate in the study.
* Patients undergoing mechanical colon preparation the day before surgery.
* Patients with rectal cancer
* Patients with intra-abdominal sepsis before surgery (abscess, diverticulitis).
* Patients who received preoperative antibiotics for any reason in the two weeks prior to surgery.
* Patients with inflammatory bowel disease (ulcerative colitis, Crohn's disease and indeterminate colitis)
* Patients presenting allergy to the drugs under study.
* Patients that will not strictly follow the assigned prophylaxis regimen
* Patients undergoing urgent surgery (\<24h)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Universitari Vall d'Hebron Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Eloy Espin Basany, MD PhD

Role: STUDY_CHAIR

Hospital Universitari Vall d'Hebron Research Institute

Locations

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Hospital de Bellvitge

L'Hospitalet de Llobregat, Barcelona, Spain

Site Status

Hospital General Universitario Vall d´Hebron

Barcelona, , Spain

Site Status

Hospital Universitari de Girona Dr. Josep Trueta

Girona, , Spain

Site Status

Countries

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Spain

References

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Espin Basany E, Solis-Pena A, Pellino G, Kreisler E, Fraccalvieri D, Muinelo-Lorenzo M, Maseda-Diaz O, Garcia-Gonzalez JM, Santamaria-Olabarrieta M, Codina-Cazador A, Biondo S. Preoperative oral antibiotics and surgical-site infections in colon surgery (ORALEV): a multicentre, single-blind, pragmatic, randomised controlled trial. Lancet Gastroenterol Hepatol. 2020 Aug;5(8):729-738. doi: 10.1016/S2468-1253(20)30075-3. Epub 2020 Apr 21.

Reference Type DERIVED
PMID: 32325012 (View on PubMed)

Other Identifiers

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2014-002345-21

Identifier Type: -

Identifier Source: org_study_id

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