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After colon and rectal surgery, unacceptably high infection rates have been reported when no prophylactic (preventive) antibiotic treatment is used. Mechanical cleansing of the intestine before surgery decreases the amount of feces and the risk of bacterial contamination, but has little effect on the colony count of bacteria. Systemic antibiotics have been shown to be more effective in these patients than oral antibiotics. Recently, blood transfusion given around the time of surgery has been associated with increased risk of postoperative infection. A prospective study of 311 patients undergoing colon-rectal surgery was performed to determine the effect of two different single doses of antibiotics and a triple dose of antibiotic. The influence of blood transfusion on the development of postoperative infections was also examined. The two different single doses were administered at the time of surgery; the triple-dose therapy was given at the time of surgery and at 8 and 16 hours later. The overall infection rate was 19 percent (59 patients); there were no significant differences among the three antibiotic treatment groups. There were 202 patients who required blood transfusion during hospitalization, and the infection rate among these patients was 28.2 percent (57 patients). Two patients who did not receive blood transfusions developed infections. It is concluded that a single dose of antibiotic is as effective as a triple dose in preventing postoperative infection following colorectal surgery. There was a strong relationship between blood transfusion and the development of postoperative infection, despite the use of antibiotic prophylaxis. (Consumer Summary produced by Reliance Medical Information, Inc.)