Abstract
We assessed the clinical impact of the systemic use of antibiotics on postoperative infection in colorectal surgery. Perioperative administration prevents postoperative infection: a statement which is based on the results of five randomized controlled trials performed in the 1970s and 1980s. Our study design was a randomized controlled trial. We created two groups, one using the systemic antibiotic cefotiam (CTM), and the other using no antibiotic as the control. The primary end point was the overall postoperative infection rate. There were 100 patients assigned to this study. The patients were divided into two groups; the control group consisted of 51 cases and the CTM group had 49 cases. The backgrounds of the patients in the two groups were not significantly different. The overall postoperative infection rate was 28/51 (54.9%) in the control group and 25/49 (51.0%) in the CTM group. The surgical site infection (SSIs) (superficial, deep, and space/organ ) were 23/51 (45.1%) in the control group and 20/49 (40.8%) in the CTM group. No significant difference was observed between the CTM group and the control group regarding postoperative infection after elective colorectal surgery.
Similar content being viewed by others
References
Utley RJ, Macbeth WAAG. Peroperative cefoxitin. A doubleblind prospective study in the prevention of wound infections. J R Coll Surg Edinb 1984;29(3):143–146.
Schiessel R, Huk I, Starlinger M, Wunderlich M, Rotter M, Wewalka G. et al. Postoperative infections in colonic surgery after enteral bacitracin-neomycin-clindamycin or parenteral mezlocillin-oxacillin prophylaxis. J Hosp Infect 1984;5:289–297.
Gomez-Alonso A, Lozano F, Perez A, Almazan A, Abdel-Lah A, Cuadrado F. Systemic prophylaxis with gentamicin-metronidazole in appendectomy and colorectal surgery: a prospective controlled clinical study. Int Surg 1984;69:17–20.
Schoetz DJ Jr, Roberts PL, Murray JJ, Coller JA, Veidenheimer MC. Addition of parenteral cefoxitin to a regimen of oral antibiotics for elective colorectal operations. A randomized prospective study. Ann Surg 1990;212(2):209–212.
Finn G, Poul D, Keld S, Soren V, Jorgen O, Ole B. Prophylaxis with whole gut irrigation and antimicrobials in colorectal surgery. A prospective, randomized double-blind clinical trial. Am J Surg 1985;149:317–322.
Alicia JM. Guidelines for the prevention of surgical site infection. Hospital Infection Control Practices Advisory Committee, 1999.
Takaya S, Keisuke S. Guidelines for antimicrobial use. Japanese Journal of Chemotherapy and Japanese Association for Infectious Disease, 2007.
Malhotra-Kumar S, Lammens C, Coenen S, Van Herck K, Goossens H. Effect of azithromycin and clarithromycin therapy on pharyngeal carriage of macrolide-resistant streptococci in healthy volunteers. A randomized, double-blind, placebo-controlled study. Lancet 2007;369:482–490.
Lau WY, Chu KW, Poon GP, Ho KK. Prophylactic antibiotics in elective colorectal surgery. Br J Surg 1988;75(8):782–785.
Tonelli F. Antimicrobial chemoprophylaxis in colorectal surgery. Chemotherapy 1988;7(4):223–228.
Jevtic M, Petrovic M, Stankovic N. Antibiotic prophylaxis in elective colorectal surgery. Vojnosanit Pregl 1993;50(3):251–255.
Gul YA, Lian LH, Jabar FM, Moissinac K. Antibiotic prophylaxis in elective colorectal surgery. ANZ J Surg 2002;72(4):275–278.
Espin-Basany E, Sanchez-Garcia JL, Lopez-Cano M, Lozoya-Trujillo R, Medarde-Ferrer M, Armadans-Gil L, et al. Prospective, randomised study on antibiotic prophylaxis in colorectal surgery. Is it really necessary to use oral antibiotics? Int J Colorectal Dis 2005;20(6):542–546.
Sanderson PJ. Antimicrobial prophylaxis in surgery: microbiological factors. J Antimicrob Chemother 1993;31:Suppl B:1–9.
Song F, Glenny AM. Antimicrobial prophylaxis in colorectal surgery: a systematic review of randomized controlled trials. Br J Surg 1998;5:1232–1241.
Nichols RL. Use of prophylactic antibiotics in surgical practice. Am J Med 1981;70:686–692.
Wren SM, Ahmed N, Jamal A, Safadi BY. Preoperative oral antibiotics in colorectal surgery increase the rate of Clostridium difficile colitis. Arch Surg 2005;140(8):752–756.
National Nosocomial Infections Surveillance (NNIS) System Report. Data summary from January 1992 through June 2004. Issued October. Am J Infect Control 2004;32:470–485.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Sato, T., Takayama, T., Fujii, M. et al. Systemic use of antibiotics does not prevent postoperative infection in elective colorectal surgery: a randomized controlled trial. J Infect Chemother 15, 34–38 (2009). https://doi.org/10.1007/s10156-008-0660-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10156-008-0660-x