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Rate of wound sepsis with “selective” short-term antibiotic prophylaxis in gastric surgery

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Abstract

A policy of selective antibiotic prophylaxis was used in 75 consecutive patients undergoing elective gastric operation. Only patients with preoperative bacterial counts in the gastric aspirate exceeding 106 organisms/ml were given antibiotics, and the choice of agent was determined by preoperative gastric culture. Using this policy, only 8% of patients developed wound sepsis and only 19 patients received an antibiotic. There was a close correlation between the pH of the gastric aspirate and bacterial contamination, which indicates that the measurement of the pH may serve as a basis for prophylactic antibiotic administration and obviate the need for elaborate preoperative bacteriological studies. The results were significantly better than in a previous group of 73 patients who were given no antibiotic cover irrespective of the preoperative gastric microflora.

Résumé

Sur une série de 75 malades qui devaient subir une intervention gastrique à froid, il a été décidé d'avoir recours à une antibiothérapie préventive. Seuls parmi eux, ceux dont le nombre des bactéries contenues dans le suc gastrique aspiré puis cultivé dépassait 106 organismes/ml ont reçu l'antibiotique sélectif. 19 malades furent ainsi traités cependant que 8% des opérés développaient une infection pariétale. Il fut constaté au cours de cette étude une corrélation étroite entre le pH du suc gastrique aspiré et sa richesse en bactéries si bien que la simple mesure du pH peut servir de base pour adopter l'antibiothérapie préventive et éviter ainsi des études bactériologiques plus astreignantes.

De toute façon les résultats qui ont été obtenus en suivant cette politique furent supérieurs à ceux observés chez un groupe de 73 malades qui ne reçurent pas une couverture antibiotique déterminée en fonction de la flore microbienne contenue dans le suc gastrique aspiré.

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Correspondence to Michael R. B. Keighley M.S., F.R.C.S..

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Keighley, M.R.B., Burdon, D.W. & Gatehouse, D. Rate of wound sepsis with “selective” short-term antibiotic prophylaxis in gastric surgery. World J. Surg. 6, 445–449 (1982). https://doi.org/10.1007/BF01657678

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Keywords

  • Antibiotic Prophylaxis
  • Close Correlation
  • Bacterial Count
  • Bacterial Contamination
  • Gastric Operation