Comparison between oral antibiotics and probiotics as bowel preparation for elective colon cancer surgery to prevent infection: Prospective randomized trial

Sadahiro, Sotaro; Suzuki, Toshiyuki; Tanaka, Akira; Okada, Kazutake; Kamata, Hiroko; Ozaki, T.; Koga, Yuichi

doi:10.1016/j.surg.2013.06.002

Cited by 133 publications

(163 citation statements)

References 41 publications

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“…A further three studies were excluded as they were duplicate publications using cohorts already included in the meta‐analysis11, 12, 13. The remaining 22 studies were included in the review, of which 14 were RCTs14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, and eight were observational cohorts2 4, 28, 29, 30, 31, 32, 33 ( Table 1; Table S1, supporting information). These studies included a total of 57 207 patients.…”

Section: Resultsmentioning

confidence: 99%

“…In the 14 RCTs14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, involving 3014 patients, rates of SSI in patients given preoperative oral antibiotic prophylaxis, in combination with i.v. antibiotic prophylaxis and MBP, were compared with those in patients who received only i.v.…”

Section: Resultsmentioning

confidence: 99%

“…Seven RCTs15 19, 22 23, 25, 26, 27 and one cohort study28, involving 2429 patients, examined rates of SSI in patients who received a preoperative oral combination of an oral aminoglycoside (kanamycin or neomycin) and metronidazole, along with i.v. antibiotic prophylaxis and MBP, in comparison with patients given only i.v.…”

Section: Resultsmentioning

confidence: 99%

“…Six RCTs17 18, 21 22, 26 27, involving 1417 patients, examined rates of anastomotic leak in patients undergoing colorectal surgery who were given preoperative oral antibiotic prophylaxis, in combination with i.v. antibiotic prophylaxis and MBP, and in those who received only i.v.…”

Section: Resultsmentioning

confidence: 99%

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Meta‐analysis of oral antibiotics, in combination with preoperative intravenous antibiotics and mechanical bowel preparation the day before surgery, compared with intravenous antibiotics and mechanical bowel preparation alone to reduce surgical‐site infections in elective colorectal surgery

2018

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BackgroundSurgical‐site infection (SSI) is a potentially serious complication following colorectal surgery. The present systematic review and meta‐analysis aimed to investigate the effect of preoperative oral antibiotics and mechanical bowel preparation (MBP) on SSI rates.MethodsA systematic review of PubMed, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials was performed using appropriate keywords. Included were RCTs and observational studies reporting rates of SSI following elective colorectal surgery, in patients given preoperative oral antibiotic prophylaxis, in combination with intravenous (i.v.) antibiotic prophylaxis and MBP, compared with patients given only i.v. antibiotic prophylaxis with MBP. A meta‐analysis was undertaken.ResultsTwenty‐two studies (57 207 patients) were included, of which 14 were RCTs and eight observational studies. Preoperative oral antibiotics, in combination with i.v. antibiotics and MBP, were associated with significantly lower rates of SSI than combined i.v. antibiotics and MBP in RCTs (odds ratio (OR) 0·45, 95 per cent c.i. 0·34 to 0·59; P < 0·001) and cohort studies (OR 0·47, 0·44 to 0·50; P < 0·001). There was a similarly significant effect on SSI with use of a combination of preoperative oral aminoglycoside and erythromycin (OR 0·40, 0·25 to 0·64; P < 0·001), or preoperative oral aminoglycoside and metronidazole (OR 0·51, 0·39 to 0·68; P < 0·001). Preoperative oral antibiotics were significantly associated with reduced postoperative rates of anastomotic leak, ileus, reoperation, readmission and mortality in the cohort studies.ConclusionOral antibiotic prophylaxis, in combination with MBP and i.v. antibiotics, is superior to MBP and i.v. antibiotic prophylaxis alone in reducing SSI in elective colorectal surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Meta‐analysis of oral antibiotics, in combination with preoperative intravenous antibiotics and mechanical bowel preparation the day before surgery, compared with intravenous antibiotics and mechanical bowel preparation alone to reduce surgical‐site infections in elective colorectal surgery

2018

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“…Não demonstra efeitos sobre as concentrações de IL-6, PCR e contagem diferencial de leucócitos 29 , sendo ineficaz na prevenção ou redução dos sintomas intestinais pós-operatórios associados à "síndrome de ressecção anterior" em pacientes que sofreram a reversão de uma ileostomia em alça 21 . Os pesquisadores ressaltaram que os antibióticos orais foram mais eficazes na prevenção da infecção pós-operatória em cirurgias eletivas de câncer de cólon do que os probióticos 23 . Por outro lado, Gao et al 5 mostraram que a utilização de probióticos no pré-operatório aumentou o número de microrganismos benéficos, proporcionando uma maior diversidade da microbiota intestinal, além de inibir potenciais agentes patogênicos.…”

Section: Discussionunclassified

Uso De Pré, Pró E Simbióticos Como Coadjuvantes No Tratamento Do Câncer Colorretal

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Association of Mechanical Bowel Preparation and Oral Antibiotics Before Elective Colorectal Surgery With Surgical Site Infection

et al. 2018

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Key Points Question Which approach is best to reduce surgical site infections and anastomotic leak in colorectal surgery: mechanical bowel preparation with oral antibiotics, oral antibiotics only, mechanical bowel preparation only, or no preparation? Findings Among 38 randomized clinical trials (8458 patients) in this network meta-analysis, mechanical bowel preparation with oral antibiotics was associated with the lowest rate of surgical site infections, reducing both incisional and organ/space infections. There was no significant difference in anastomotic leak rate between the 4 approaches. Meaning Mechanical bowel preparation with oral antibiotics is the best approach to reduce surgical site infections in patients undergoing colorectal surgery.

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Comparison between oral antibiotics and probiotics as bowel preparation for elective colon cancer surgery to prevent infection: Prospective randomized trial

Cited by 133 publications

References 41 publications

Meta‐analysis of oral antibiotics, in combination with preoperative intravenous antibiotics and mechanical bowel preparation the day before surgery, compared with intravenous antibiotics and mechanical bowel preparation alone to reduce surgical‐site infections in elective colorectal surgery

Meta‐analysis of oral antibiotics, in combination with preoperative intravenous antibiotics and mechanical bowel preparation the day before surgery, compared with intravenous antibiotics and mechanical bowel preparation alone to reduce surgical‐site infections in elective colorectal surgery

Uso De Pré, Pró E Simbióticos Como Coadjuvantes No Tratamento Do Câncer Colorretal

Association of Mechanical Bowel Preparation and Oral Antibiotics Before Elective Colorectal Surgery With Surgical Site Infection

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