Search tips
Search criteria 


Logo of jrsocmedLink to Publisher's site
J R Soc Med. 1988 February; 81(2): 95–96.
PMCID: PMC1291475

Are we using the correct dose of metronidazole in colorectal surgery?


In a series of 20 patients undergoing elective colorectal surgery, 10 received an infusion of metronidazole 500 mg and 10 an infusion of 1500 mg commencing at the induction of anaesthesia. The concentrations of metronidazole in the plasma, rectus muscle and colon of the two groups during the course of the operation were compared. In those patients who received 1500 mg, the plasma and tissue concentrations were all well above the minimum inhibitory concentration (MIC) of metronidazole against Bacteroides fragilis. In those patients who received 500 mg, serum and tissue concentrations were at or only just above the MIC. It may be that 1500 mg would be a more effective dose of metronidazole for prophylactic use in colorectal surgery.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (382K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Everett MT, Brogan TD, Nettleton J. The place of antibiotics in colonic surgery: a clinical study. Br J Surg. 1969 Sep;56(9):679–684. [PubMed]
  • Burton RC. Postoperative wound infection in colonic and rectal surgery. Br J Surg. 1973 May;60(5):363–365. [PubMed]
  • Eykyn SJ, Jackson BT, Lockhart-Mummery HE, Phillips I. Prophylactic peroperative intravenous metronidazole in elective colorectal surgery. Lancet. 1979 Oct 13;2(8146):761–764. [PubMed]
  • Willis AT, Ferguson IR, Jones PH, Phillips KD, Tearle PV, Fiddian RV, Graham DF, Harland DH, Hughes DF, Knight D, et al. Metronidazole in prevention and treatment of bacteroides infections in elective colonic surgery. Br Med J. 1977 Mar 5;1(6061):607–610. [PMC free article] [PubMed]
  • Keighley MR, Arabi Y, Alexander-Williams J, Youngs D, Burdon DW. Comparison between systemic and oral antimicrobial prophylaxis in colorectal surgery. Lancet. 1979 Apr 28;1(8122):894–897. [PubMed]
  • Mitchell NJ, Evans DS, Pollock D. Pre-operation single-dose cefuroxime antimicrobial prophylaxis with and without metronidazole in elective gastrointestinal surgery. J Antimicrob Chemother. 1980 May;6(3):393–399. [PubMed]
  • Carr ND, Hobbiss J, Cade D, Schofield PF. Metronidazole in the prevention of wound sepsis after elective colorectal surgery. J R Coll Surg Edinb. 1984 May;29(3):139–142. [PubMed]
  • Kaye CM, Sankey MG, Thomas LA. A rapid and specific semi-micro method involving high-pressure liquid chromatography for the assay of metronidazole in plasma, saliva, serum, urine and whole blood. Br J Clin Pharmacol. 1980 May;9(5):528–529. [PMC free article] [PubMed]
  • Tally FP, Sutter VL, Finegold SM. Metronidazole versus anaerobes. In vitro data and initial clinical observations. Calif Med. 1972 Dec;117(6):22–26. [PMC free article] [PubMed]
  • Gjerløff C, Arnold E. Pharmacokinetics of intravenous metronidazole in man. Acta Pharmacol Toxicol (Copenh) 1982 Aug;51(2):132–135. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press