A Brief Course of Colon Preparation with Oral Antibiotics

Abstract

We carried out a prospective clinical trial of colon preparation with a regimen of oral antibiotics starting on the day before surgery. The patients were assigned to one of two groups consisting of either a mechanical preparation alone group (group 1, 45 cases) or a mechanical bowel preparation with oral antibiotics group (group 2, 38 cases). Group 2 received kanamycin and metronidazole three times on the day before surgery. Cefmetazole was administered for 3 consecutive days as prophylaxis in both groups. In a study using intraoperative mucosal swabs, the rates of group 2 patients with cultures yielding anaerobes or Gram-negative bacteria were significantly lower than those of group 1. There were no significant differences in the rates of patients with cultures yielding fungi or Gram-positive organisms. The positive culture rate in the peritoneal fluid of group 1 was also higher than that of group 2 (40%, 16%, P < 0.05). The surgical site infection rate was 18% in group 1 and 13% in group 2. Organisms isolated from the sites of postoperative infections were not identical with those from the peritoneal fluid. This relatively brief course preparation minimized the emergence of resistant strains. However, in spite of the colonic bacterial burden and the intraoperative inoculation in the patients with mechanical cleansing alone, their incidence of subsequent infections was comparable to that of patients who were administered oral antibiotics provided that the prophylactic antibiotic was administered for 3 days after surgery.

Comparative Prophylactic Administration Effect of Metronidazole, Ceftriaxone Sodium and their Combination on the Tensile Strength of End-to-End Jejunal Anastmotic Site in Dogs

“…It was observed that during study, the animals of this group had suffered from fever for three to four days that's why the gain in the tensile strength was lower than the groups having single dose of intravenous antibiotic prophylaxis. These findings are also inline with those of Athar et al, Cai (1992) , Leaper (1994), Lindhagen et al, (1981), Mittermayer et al, (1984) Ono et al, (1990) Parker et al, (1985 Playforth et al, (1988) and Takesue et al, (2000). As for the choice of antimicrobial agents, it is general consensus worldwide that administration of prophylactic antibiotics should be intravenous as single dose preferably 1 hour to 30 minutes before surgery.…”

Short-term intravenous antimicrobial prophylaxis in combination with preoperative oral antibiotics on surgical site infection and methicillin-resistant Staphylococcus aureus infection in elective colon cancer surgery: Results of a prospective randomized trial

“…The overall incidence of surgical site infection (5.8%) in this study is considered identical to or lower than those recently reported [16][17][18] from Japan. There has been only one report other than this study that has assessed the method of perioperative antimicrobial prophylaxis according to CDC guidelines.…”

Combination of oral non-absorbable and intravenous antibiotics versus intravenous antibiotics alone in the prevention of surgical site infections after colorectal surgery: a meta-analysis of randomized controlled trials

“…2). The 16 studies included in the meta-analysis are outlined in Table 1 [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. No eligible trial was found prior to 1980, and the first trial included in the SWI meta-analysis was from 1982.…”