Comparison between oral and systemic antibiotics and their combined use for the prevention of complications in colorectal surgery

Abstract

Ninety patients were included in this prospective randomized trial. Each required electric colorectal surgery and was prepared for operation with oral preoperative antibiotic therapy, systemic peroperative therapy, or by a combination of both. The number of each type of septic postoperative complication and their total did not differ between the group treated by oral antibiotics prior to operation and the group treated peroperatively with systemic antibiotic therapy. The total number of septic complications (wall abscesses, fistulas, subdiaphragmatic abscesses, septicemia, peritonitis), however, was significantly less (P less than 0.05) in the group treated by both preoperative oral antibiotics and peroperative systemic antibiotic therapy (3.3 per cent) than in either groups treated only orally preoperatively (30 per cent) or by systemic antibiotic therapy during the operation (23 per cent). The combination of oral antibiotic therapy prior to operation and of systemic peroperative antibiotic therapy, therefore, presents the most effective prophylactic effectiveness.

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.…”

“…Of the antibiotic regimens used in the intravenous antibiotic only arms, only 2 studies utilized a regimen that is not currently recommended by the Surgical Care Improvement Project (SCIP) guidelines [20,21,29]. In 3 other studies (2 of which included in the SWI meta-analysis), the intravenous antibiotics regimen had reduced gram-negative coverage [13,14,16]. In 6 of the 16 studies the intravenous antibiotics used in combination with oral antibiotics were not the same ones used in the intravenous antibiotic only arm (Table 1).…”

Perioperative Management of Patients Undergoing Elective Colorectal Surgery in Israel: A National Survey

“…The issue of the best route of perioperative antibiotic prophylaxis is still controversial, because both parenteral and oral antibiotic prophylaxis is effective in colon surgery [15][16][17][18]. Most studies evaluated the effect of adjunctive parenteral antibiotics after oral antibiotic prophylaxis, or compared the effect of the two routes of administration [8,15,16,19].…”

The Truth Is in the Dialogue

“…The results demonstrated that the two methods together yielded a 5% rate of surgical site infection whereas the patients who received only systemic antibiotics and no oral antibiotic bowel preparation had a 16% rate of surgical site infection. In this same publication, Lewis identified 12 additional studies where systemic antibiotics were compared to systemic plus oral antibiotics in colon surgery (Table 2) [24][25][26][27][28][29][30][31][32][33][34][35]. The meta-analysis demonstrated marked statistical significance (p Ͻ 0.0001) in favor of lower surgical site infections with combinations of the two methods.…”