Search tips
Search criteria 


Logo of aacPermissionsJournals.ASM.orgJournalAAC ArticleJournal InfoAuthorsReviewers
Antimicrob Agents Chemother. 1989 June; 33(6): 835–838.
PMCID: PMC284241

Suppression of colonic microflora by cefoperazone and evaluation of the drug as potential prophylaxis in bowel surgery.


We evaluated the activity of cefoperazone (CPZ) on the intestinal flora in terms of its use as a single prophylactic drug in colon surgery. Twenty-four healthy male volunteers between the ages of 20 and 40 were assigned to receive either CPZ, oral neomycin-erythromycin, or no antibiotics. A mechanical bowel preparation, Golytely, was also given to each of the subjects. With intravenous CPZ, antibiotic levels in the stool ranged from less than 2 to 649 micrograms/ml and the total fecal bacterial counts dropped 3 to 4 log10 CFU/g. Higher levels of CPZ were detected in the stools when an oral dose was added, 1,446 to 5,445 micrograms/ml, and the bacterial counts were reduced maximally 4 to 6 log10 CFU/g. The combination of the oral and intravenous doses produced suppression of the microflora and high levels in blood, all with a single antibiotic.

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 (694K), 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.
  • Alestig K, Carlberg H, Nord CE, Trollfors B. Effect of cefoperazone on faecal flora. J Antimicrob Chemother. 1983 Aug;12(2):163–167. [PubMed]
  • Ambrose NS, Johnson M, Burdon DW, Keighley MR. The influence of single dose intravenous antibiotics on faecal flora and emergence of Clostridium difficile. J Antimicrob Chemother. 1985 Mar;15(3):319–326. [PubMed]
  • Bartlett JG, Condon RE, Gorbach SL, Clarke JS, Nichols RL, Ochi S. Veterans Administration Cooperative Study on Bowel Preparation for Elective Colorectal Operations: impact of oral antibiotic regimen on colonic flora, wound irrigation cultures and bacteriology of septic complications. Ann Surg. 1978 Aug;188(2):249–254. [PubMed]
  • Chang TW, Lauermann M, Bartlett JG. Cytotoxicity assay in antibiotic-associated colitis. J Infect Dis. 1979 Nov;140(5):765–770. [PubMed]
  • Clarke JS, Condon RE, Bartlett JG, Gorbach SL, Nichols RL, Ochi S. Preoperative oral antibiotics reduce septic complications of colon operations: results of prospective, randomized, double-blind clinical study. Ann Surg. 1977 Sep;186(3):251–259. [PubMed]
  • Coppa GF, Eng K, Gouge TH, Ranson JH, Localio SA. Parenteral and oral antibiotics in elective colon and rectal surgery. A prospective, randomized trial. Am J Surg. 1983 Jan;145(1):62–65. [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]
  • Giuliano M, Barza M, Jacobus NV, Gorbach SL. Effect of broad-spectrum parenteral antibiotics on composition of intestinal microflora of humans. Antimicrob Agents Chemother. 1987 Feb;31(2):202–206. [PMC free article] [PubMed]
  • Greenfield RA, Gerber AU, Craig WA. Pharmacokinetics of cefoperazone in patients with normal and impaired hepatic and renal function. Rev Infect Dis. 1983 Mar-Apr;5 (Suppl 1):S127–S136. [PubMed]
  • Jones RN, Barry AL. Cefoperazone: a review of its antimicrobial spectrum, beta-lactamase stability, enzyme inhibition, and other in vitro characteristics. Rev Infect Dis. 1983 Mar-Apr;5 (Suppl 1):S108–S126. [PubMed]
  • Kager L, Malmborg AS, Nord CE, Sjöstedt S. The effect of piperacillin prophylaxis on the colonic microflora In patients undergoing colorectal surgery. Infection. 1983 Sep-Oct;11(5):251–254. [PubMed]
  • Mulligan ME, Citron D, Gabay E, Kirby BD, George WL, Finegold SM. Alterations in human fecal flora, including ingrowth of Clostridium difficile, related to cefoxitin therapy. Antimicrob Agents Chemother. 1984 Sep;26(3):343–346. [PMC free article] [PubMed]
  • Mulligan ME, Citron DM, McNamara BT, Finegold SM. Impact of cefoperazone therapy on fecal flora. Antimicrob Agents Chemother. 1982 Aug;22(2):226–230. [PMC free article] [PubMed]
  • Nakamura T, Hashimoto I, Sawada Y, Mikami J, Bekki E, Hirasawa S, Abe H, Watanabe Y. Cefoperazone concentrations in bile and gall bladder wall after intravenous administration. Antimicrob Agents Chemother. 1980 Dec;18(6):980–982. [PMC free article] [PubMed]
  • Neu HC. The new beta-lactamase-stable cephalosporins. Ann Intern Med. 1982 Sep;97(3):408–419. [PubMed]
  • Nichols RL, Broido P, Condon RE, Gorbach SL, Nyhus LM. Effect of preoperative neomycin-erythromycin intestinal preparation on the incidence of infectious complications following colon surgery. Ann Surg. 1973 Oct;178(4):453–462. [PubMed]
  • Stone HH, Hooper CA, Kolb LD, Geheber CE, Dawkins EJ. Antibiotic prophylaxis in gastric, biliary and colonic surgery. Ann Surg. 1976 Oct;184(4):443–452. [PubMed]
  • Viscidi R, Willey S, Bartlett JG. Isolation rates and toxigenic potential of Clostridium difficile isolates from various patient populations. Gastroenterology. 1981 Jul;81(1):5–9. [PubMed]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)