Serum concentrations of amoxicillin, metronidazole and gentamicin
Research type
Research Study
Full title
Serum concentrations of amoxicillin, metronidazole and gentamicin for antibiotic prophylaxis in colorectal surgery
IRAS ID
186630
Contact name
Michael da Silva Neto
Contact email
Sponsor organisation
NHS Greater Glasgow & Clyde
Duration of Study in the UK
0 years, 5 months, 30 days
Research summary
Infections related to a surgical procedure are one of the most frequent causes of hospital acquired infections in Scotland. The risk of becoming infected is highest when the surgery involves the lower part of the gut (colorectal surgery). Developing an infection can delay recovery following surgery, prolong the patient’s stay in hospital, increase costs and may put the patient’s life at risk.
Antibiotics are routinely administered to patients before surgery to reduce the risk of infection. Some antibiotics are eliminated from the body very quickly and if the operation is long, additional doses are given to ensure adequate antibiotic concentrations are maintained at the surgical site. However, there is uncertainty about how frequently antibiotics should be administered. A recently updated guideline from the Scottish Intercollegiate Guidelines Network (SIGN) highlights the need for further research in this area.
Our institution uses a combination of three antibiotics, gentamicin, metronidazole and amoxicillin, prior to colorectal surgery. However, there is no consensus on the optimal concentrations and doses of these antibiotics when used for prophylaxis and there are concerns about the potential for toxicity with high doses. It is known that other national and international recommendations suggest higher doses of these antibiotics than the doses currently recommended by our institution but no studies have investigated concentrations achieved by the combination of antibiotics and dosage regimens used within our institution for colorectal surgery.
The primary aim of this study is to determine whether current prophylactic dosage regimens of amoxicillin, metronidazole and gentamicin provide adequate serum concentrations to reduce the risk of infection for the duration of prolonged colorectal surgery.
REC name
East Midlands - Nottingham 1 Research Ethics Committee
REC reference
16/EM/0209
Date of REC Opinion
18 May 2016
REC opinion
Further Information Favourable Opinion