Importance of Adding Neomycin to Metronidazole for Bowel Preparation<sup>1</sup>

Vallance, Shirley; Jones, Brian M.; Arabi, Y.; Keighley, M. R. B.

doi:10.1177/014107688007300405

Cited by 10 publications

(4 citation statements)

References 13 publications

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“…The methods advocated range from mechanical washout alone as suggested by the study of Burdon et al [3] to the use of various forms and combinations of antibiot ics in addition to colon washout as advocated by many workers [ 15,24,25]. These methods are represented, at least in principle, by the 4 methods described in this study.…”

Section: Discussionmentioning

confidence: 97%

Clinical Studies of 4 Methods of Bowel Preparation in Colorectal Surgery

Adeyemi¹,

Rocha-Afodu²

1986

Eur Surg Res

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A prospective study was carried out to compare the effectiveness of 4 commonly employed methods of bowel preparation before colorectal surgery: mechanical, mechanical with an antibiotic against aerobes (neomycin), mechanical with another antibiotic against anaerobes (metronidazole), and finally mechanical with a combination of neomycin and metronidazole. The use of mechanical preparation as the sole method was discontinued halfway through the study for ethical reasons. 53 bowel preparations were carried out on 31 patients, 7 adults and 24 children with mainly Hirschsprung’s disease and imperforate anus. The incidence of postoperative infections ranged from 40 to 46% in the first 3 groups, in contrast to only 6% in the fourth group (p < 0.05). The majority of the organisms isolated were gram-negative bacteria. The results show that a combination of mechanical bowel washout with oral neomycin and metronidazole is a most effective method of bowel preparation before colorectal surgery.

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Section: Discussionmentioning

confidence: 97%

Clinical Studies of 4 Methods of Bowel Preparation in Colorectal Surgery

Adeyemi¹,

Rocha-Afodu²

1986

Eur Surg Res

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“…This combination of drugs has been used in the past, but in association with general surgery of the digestive tract. The pre-operatory administration was revealed to be an efficient combination of antibiotics that leads to a significant reduction of post-operatory infections (18,19).…”

Section: Discussionmentioning

confidence: 99%

Periodontal effects of two innovative oral rinsing substances in oncologic patients

et al. 2020

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Chemotherapy often presents side effects, including oral adverse effects that may interfere with the completion of the oncology treatment, threatening the outcome of the treatment and significantly affecting the quality of life of the patient. The aim of the present study was to evaluate two antiseptic, antimicrobial and antifungal substances that may be used in order to achieve improved oral hygiene and to lower the prevalence of side effects during chemotherapy. Patients were randomly divided into three groups: Placebo, oral rinse with cetrimide and mouth coating with a pharmacy-made compound (nystatin, neomycin and metronidazole). Their oral hygiene and periodontal parameters were determined at baseline and 14 days of use. It was revealed that the most effective clinical results were achieved in the group that used cetrimide mouth rinse that highlighted the best improvements of parameter values, whereas the control and coating-using group did not obtain statistically significant improvements. Cetrimide oral rinse was demonstrated to be an efficient adjunct method in achieving better oral hygiene and improved periodontal parameters in chemotherapy patients. The present study offers an alternative to the commonly used compounds that may present unwanted side effects in patients during chemotherapy, it promotes the importance of good oral hygiene in the prevention of chemotherapy-induced oral adverse effects and improves the quality of life of the patient.

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“… 14 Metronidazole has been recently substituted for the erythromycin due to its seemingly increased efficacy against anaerobic microorganisms in the gut. 15 16 Using doses similar to those prescribed to individual patients, we find that this prophylactic therapy, although is efficient for clearing most gut anaerobes, is ineffective for clearing those of the Bacteroidetes phylotype from the murine intestine. Moreover, we find that prophylactic treatment followed by intestinal barrier damage induced more rapid death kinetic compared with antibiotic-free mice.…”

Section: Introduction and Rationalementioning

confidence: 96%

The common prophylactic therapy for bowel surgery is ineffective for clearing Bacteroidetes, the primary inducers of systemic inflammation, and causes faster death in response to intestinal barrier damage in mice

Sinsimer

Esseghir

Tang

et al. 2014

BMJ Open Gastroenterol

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Introduction and objectiveThe role of secreted gut microbial components in the initiation of systemic inflammation and consequences of antibiotic therapies on this inflammatory process are poorly elucidated. We investigate whether peripheral innate cells mount an inflammatory response to gut microbial components, the immune cells that are the primary drivers of systemic inflammation, the bacterial populations that are predominantly responsible, and whether perioperative antibiotics affect these processes.Method and experimental designConditioned supernatants from gut microbes were used to stimulate murine innate cell types in vitro and in vivo, and proinflammatory responses were characterised. Effects of antibiotic therapies on these responses were investigated using a model of experimental intestinal barrier damage induced by dextran sodium sulfate.ResultsProinflammatory responses in the periphery are generated by components of anaerobes from the Bacteroidetes phylotype and these responses are primarily produced by myeloid dendritic cells. We found that the common prophylactic therapy for sepsis (oral neomycin and metronidazole administered to patients the day prior to surgery) is ineffective for clearing Bacteroidetes from the murine intestine. A point of critical consequence of this result is the increased systemic inflammation and premature death observed in treated mice, and these outcomes appear to be independent of gut bacterial spread in the initial phase of intestinal barrier damage. Importantly, spillage of gut microbial products, rather than dissemination of gut microbes, may underlay the initiation of systemic inflammation leading to death.ConclusionsOur data further affirm the importance of a balanced gut microflora biodiversity in host immune homeostasis and reinforce the notion that inadequate antibiotic therapy can have detrimental effects on overall immune system.

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Importance of Adding Neomycin to Metronidazole for Bowel Preparation¹

Cited by 10 publications

References 13 publications

Clinical Studies of 4 Methods of Bowel Preparation in Colorectal Surgery

Clinical Studies of 4 Methods of Bowel Preparation in Colorectal Surgery

Periodontal effects of two innovative oral rinsing substances in oncologic patients

The common prophylactic therapy for bowel surgery is ineffective for clearing Bacteroidetes, the primary inducers of systemic inflammation, and causes faster death in response to intestinal barrier damage in mice

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Importance of Adding Neomycin to Metronidazole for Bowel Preparation1

Cited by 10 publications

References 13 publications

Clinical Studies of 4 Methods of Bowel Preparation in Colorectal Surgery

Clinical Studies of 4 Methods of Bowel Preparation in Colorectal Surgery

Periodontal effects of two innovative oral rinsing substances in oncologic patients

The common prophylactic therapy for bowel surgery is ineffective for clearing Bacteroidetes, the primary inducers of systemic inflammation, and causes faster death in response to intestinal barrier damage in mice

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Importance of Adding Neomycin to Metronidazole for Bowel Preparation¹