An Evaluation of Chemical Preparation for Prophylaxis of Postoperative Infection in Colorectal Surgery

Ishii, Yoshimasa; Wakayama, Hiroshi; Nakayama, Kouichi; Iida, Michio; Hotta, Minoru; Yamazaki, Shigeru; Takahashi, M

doi:10.3919/ringe1963.58.1969

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“…4,5 However, in Japan renewed interest has recently been focused on useful regimens of oral antimicrobial prophylaxis using parenteral antibiotics other than third-generation cephalosporins. 6,15,16 In those trials, 6,15,16 the duration of preoperative oral antibiotics ranged from 1 to 3 days, which were concurrent with this study. We therefore consider that the 2-day administration of oral antibiotics adopted in this study is permissible as long as one of the second-generation cephalosporins is used within 3 days following surgery, although a briefer course of oral antibiotics may be feasible.…”

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confidence: 98%

Impact of Oral Antimicrobial Prophylaxis on Surgical Site Infection and Methicillin-Resistant Staphylococcus aureus Infection After Elective Colorectal Surgery. Results of a Prospective Randomized Trial

et al. 2001

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The impact of oral antimicrobial prophylaxis on the surgical site infection and methicillin-resistant Staphylococcus aureus (MRSA) infection after elective colorectal surgery was evaluated by a prospective randomized single-blind study. The patients were randomly allocated to receive either mechanical bowel cleansing with polyethylene glycol alone (group 1) or mechanical cleansing plus oral antimicrobial prophylaxis with kanamycin and erythromycin for 2 days prior to surgery (group 2). In both groups, cefotiam was intravenously given twice a day for 3 days. A total of 143 patients (71 for group 1 and 72 for group 2) were eligible. The incidence of a surgical site infection was 23.9% in group 1 and 11.1% in group 2 (P = 0.04). The incidence of MRSA infection including at surgical and remote sites was 11.1% in group 1 and 5.6% in group 2 (P = 0.19). A multivariate logistic regression analysis showed that the risk of surgical site infection was influenced by the choice of the chemical bowel preparation (P = 0.03) and blood loss (P < 0.01), while an MRSA infection was predominantly influenced by blood loss (P < 0.01) followed by coexisting underlying diseases (P = 0.07). These results suggest that preoperative antimicrobial prophylaxis would be useful for reducing the incidence of a surgical site infection without increasing the risk of an MRSA infection following elective colorectal surgery.

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