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Orally delivered antibiotics which lower bacterial numbers decrease experimental intra-abdominal adhesions
C Bothin1, T Midtvedt, L Perbeck
1Department of Medical Microbial Ecology, Karolinska Institute, 14186, Stockholm, Sweden. claes.bothin@nopo.sll.se
Background:
Postsurgical adhesion formation is a common occurrence after most surgical procedures and is still a major cause of postoperative morbidity because no satisfactory treatment or prophylaxis has yet been developed. Further elucidation of the basic mechanisms of postsurgical adhesion formation is needed. Recent studies using germfree rats have found the indigenous bowel flora to be important in the adhesive response. The present study examined whether antibiotic treatment affects intra-abdominal adhesion formation.
Methods:
Using the cecal crush model to inflict adhesions, groups of rats ( n=12) were treated with placebo or amoxicillin/clavulanic acid in the drinking water. Treatment started 3 days before operation and continued until evaluation. Adhesion scores were recorded after 7 days. Bacterial counts were made from cultures of fecal samples on operation day and at termination.
Results:
Amoxicillin/clavulanic acid decreased adhesion score compared to placebo. Adhesion incidence was 50% in the treatment group and 92% in the placebo group. Bacterial numbers were lower in the treatment group.
Conclusions:
Antibiotic treatment which lowers bacterial numbers can decrease adhesions.
Insights
Antibiotic treatment significantly reduced postsurgical adhesions in rats by lowering bacterial counts. This suggests a potential new strategy for preventing adhesion formation after surgery.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Microbiome Research
Background:
- Postsurgical adhesions are a frequent complication causing significant morbidity.
- Current treatments for adhesions are limited, necessitating research into underlying mechanisms.
- The role of indigenous bowel flora in adhesion formation is increasingly recognized.
Purpose of the Study:
- To investigate the impact of antibiotic treatment on intra-abdominal adhesion formation.
- To determine if reducing bacterial load influences the development of postsurgical adhesions.
Main Methods:
- Rats underwent a cecal crush model to induce adhesions.
- Groups received either placebo or amoxicillin/clavulanic acid in drinking water.
- Adhesion scores and bacterial counts were assessed post-operation.
Main Results:
- Amoxicillin/clavulanic acid treatment led to a significant decrease in adhesion scores compared to placebo.
- Adhesion incidence was markedly lower in the antibiotic-treated group (50%) versus the placebo group (92%).
- Bacterial numbers in the treatment group were substantially reduced.
Conclusions:
- Antibiotic administration, by lowering bacterial numbers, effectively reduces postsurgical adhesion formation.
- This study highlights the potential of targeting the gut microbiome to prevent surgical adhesions.