Comparing a combination of penicillin G and gentamicin to a combination of clindamycin and amikacin as prophylactic antibiotic regimens in prevention of clean contaminated wound infections in cancer surgery

Background and aim: appropriate antibiotic selection and timing of administration for prophylaxis are crucial to reduce the likelihood of surgical site infection (ssi) after a clean contaminated cancer surgery. our aim is to compare the use of two prophylactic antibiotic (pa) regimens as regards efficacy,timing,and cost. patients and methods: two hundred patients with gastric,bladder,or colorectal cancer were randomized to receive preoperative pa,group a received penicillin g sodium and gentamicin and group b received clindamycin and amikacin intravenously. the demographic data of patients were collected,and they were observed for wound infections. results: infected wounds occurred in 19 patients with a rate of 9.5%. highest incidence of ssi was among bladder cancer patients (14.2%); p=0.044. the rate of ssi was 11% in group a,and 8% in group b,p=0.469. the cost of pa administered in group a was significantly less than that of group b (21.96±3.22 le versus 117.05±12.74 le,respectively; p<0.001). ssi tended to be higher among those who had longer time for antibiotic and incision (<30. min) than those who had shorter time interval (<30. min),(13% vs. 6.5%,respectively). conclusion: both penicillin. +. gentamicin and clindamycin. +. amikacin are safe and effective for the prevention of ssi in clean contaminated operative procedures. in a resource limited hospital,a regimen including penicillin. +. gentamicin is a cost-effective alternative for the more expensive and broader coverage of clindamycin. +. amikacin. timing of pa is effective in preventing ssis when administered 30. min before the start of surgery. © 2012.