1. Short summary / abstract
The authors have undertaken analysis of gentamicin levels in patients given prophylactic gentamicin and metronidazole for colorectal surgery. The relationship between gentamicin levels at the time of closure and the risk if post-operative infection was examined. The authors concluded that the gentamicin concentration at the time of surgical closure was one of the strongest independent risk factors for post-operative infection.
2. What question is the document addressing?
Are the intra-operative antibiotic drug levels related to risk of post-operative infection?
3. Type of study
The authors have analysed, in retrospect, data that was available from a previous prospective randomised double-blind clinical study.
4. Methods valid & appropriate?
Yes
Comments:
The findings would have had more meaning if the study had been prospective with patients known to have other risk factors for infection - e.g. diabetes, stoma - excluded from the study.
5. Results / recommendations reliable?
The results are reliable but open to interpretation e.g. does a low level of gentamicin at closure largely reflect prolonged surgery which may be a more important risk factor for infection than the antibiotic drug level.
6. Any major problems and biases?
Any study which draws on data from a previously conducted study is liable to bias i.e. the authors may have suspected an association between gentamicin levels and infection and thus looked for it in existing data rather than designed a new study to examine for a link.
7. Any other important / relevant studies which confirm or contradict?
None known
8. Keywords
Reviewer's Details:
| Name: | Rob Laing |
| Post: | Consultant Physician |
Affiliations
(Society / Organisation / Advisory Committee): | Aberdeen Royal Infirmary, BSAC |
*** Note: These are the views of a professional expert rather than an official statement from his or her society, organisation or advisory committee.