Ristocetin and Ristocetin-Neomycin for Preoperative Preparation of the Colon

Cohn, Isidore; Longacre, Alfred B.

doi:10.1001/archsurg.1958.01290020074014

Cited by 1 publication

(1 citation statement)

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“…The collective information, including conclusions about efficacy, can then be blended with conclusions about effectiveness, in order to get a more complete view of the importance of any given intervention. In the specific case involving the importance of oral antibiotics, there have been several RCTs supporting the importance of oral antibiotics as part of the bowel prep in reducing post colectomy infectious complications, and we now provide a large community based observational study which supports these conclusions 3, 14–16, 32…”

Section: Discussionmentioning

confidence: 59%

A Statewide Assessment of Surgical Site Infection Following Colectomy

et al. 2010

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Objective-To determine the utility of adding oral non-absorbable antibiotics to the bowel prep prior to elective colon surgery Summary background data-Bowel preparation prior to colectomy remains controversial. We hypothesized that mechanical bowel preparation with oral antibiotics (compared to without) was associated with lower rates of SSI. Methods-24Michigan hospitals participated in the Michigan Surgical Quality CollaborativeColectomy Best Practices Project. Standard peri-operative data, bowel preparation process measures and C.difficile colitis outcomes were prospectively collected. Among patients receiving mechanical bowel preparation, a logistic regression model generated a propensity score that allowed us to match cases differing only in whether or not they had received oral antibiotics.Results-Overall, 2011 elective colectomies were performed over 16 months. Mechanical bowel prep without oral antibiotics was administered to 49.6% of patients, while 36.4% received a mechanical prep and oral antibiotics. Propensity analysis created 370 paired cases (differing only in receiving oral antibiotics). Patients receiving oral antibiotics were less likely to have any SSI (4.5% vs.11.8%, p = 0.0001), to have an organ space infection (1.8% vs. 4.2%, p = 0.044) and to have a superficial SSI (2.6% vs. 7.6%, p = 0.001). Patients receiving bowel prep with oral antibiotics were also less likely to have a prolonged ileus (3.9% vs. 8.6%, p = 0.011) and had similar rates of C. difficile colitis (1.3% vs. 1.8%, p = 0.58).Conclusions-Most patients in Michigan receive mechanical bowel preparation prior to elective colectomy. Oral antibiotics may reduce the incidence of SSI.

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Section: Discussionmentioning

confidence: 59%