ArticleInternational journal of colorectal disease2017
The role of single-shot metronidazole in the prevention of Clostridium difficile infection following ileostomy reversal surgery.
Article in International journal of colorectal disease, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Clostridium difficile infection after stoma reversal surgery: a systematic review and meta-analysis of the literature.International journal of colorectal disease · 2024Pooled it
- Patient with Inflammatory Bowel Disease in a Dental Office-Which Antibiotic to Choose?-Narrative Review.Journal of clinical medicine · 2025Review
- C. difficile Infection in Colorectal Cancer: Risk Determinants, Outcomes, and Evolving Management Approaches.Journal of gastrointestinal cancer · 2025Review
- Risk factors and outcomes of Clostridioides difficile infection in patients with colorectal cancer: critical perspective in management.Gut pathogens · 2025Review
- Single-Centre Retrospective Audit of Clostridium difficile Infections Post Ileostomy Reversal.Cureus · 2024Article
- Clostridium difficile Infection After Ileostomy Reversal.Annals of coloproctology · 2021Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSymptomatic infection with Clostridium difficile is strongly linked to antibiotic use and rates are higher for colorectal surgery. In February 2015, trust policy for antibiotic prophylaxis of ileostomy reversal surgery was changed from three doses of metronidazole plus cefuroxime to single-dose metronidazole, in a bid to reduce rates of Clostridium difficile infection.
methodsA retrospective cohort study was conducted at a single, large hospital trust between February 2014 and February 2016, before and after change in antimicrobial policy. Theatre data, clinical notes and pathology results were all reviewed. Outcome data, patient age, gender, length of operation and hospital stay were extracted.
resultsOne hundred three patients underwent ileostomy reversal surgery between February 2014 and February 2015. All received cefuroxime together with metronidazole at induction of anaesthesia followed by two further post-operative doses as operative prophylaxis. Ninety-six patients underwent ileostomy reversal surgery between February 2015 and February 2016. All received single-dose metronidazole at induction as prophylaxis. Post-operative diarrhoea was significantly reduced in patients given single-dose metronidazole compared with patients managed with multiple dose, dual antibiotic therapy (32 vs 12.5%, P 0.001). Rates of CDI were also significantly reduced in patients given single-dose metronidazole (6.8 vs 1%, P 0.038).
conclusionsSingle-dose, pre-operative metronidazole is effective at reducing post-operative diarrhoea and CDI in ileostomy reversal surgery compared with multiple-dose cefuroxime plus metronidazole. Metronidazole may be effective as a prophylactic antibiotic against CDI in colonic surgery.
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