Metronidazole in the prevention of anaerobic infection.

One of the most common complications of appendectomy, or major colorectal surgery and gynecologic surgery, is surgical sepsis. Its incidence may vary from 2% to 4% for normal appendices, up to 20% for hysterectomy, and from 50% to 60% for some colonic operations including gangrenous or perforated appendices. During the last decade, one has become increasingly aware of the importance of non-spore-forming anaerobes as the major cause of serious sepsis associated with these types of operation. Studies carried out at the Luton and Dunstable Hospital, and subsequently at other centers, have shown that metronidazole, a specifically anaerobicidal agent without significant activity against aerobic organisms, is highly effective in preventing postoperative morbidity resulting from anaerobic infections. Moreover, its use has greatly modified the surgical approach in a number of conditions.