Antibiotic prophylaxis influences cardiovascular stability in complicated surgery

Area of Science:

• Veterinary Medicine
• Surgical Research
• Pharmacology

Background:

• Perioperative cardiovascular instability is a concern with antibiotic prophylaxis.
• A need exists to evaluate the impact of common antibiotic combinations on cardiovascular stability during major surgery.

Purpose of the Study:

• To compare the effects of co-amoxiclav and cefuroxime/metronidazole on cardiovascular stability during major surgery using a novel clinic modelling randomised trial (CMRT) in pigs.
• To assess histamine release reactions as a marker for cardiovascular instability.

Main Methods:

• A randomized controlled trial in 30 pigs, divided into placebo, co-amoxiclav, and cefuroxime/metronidazole groups.
• Simulated surgical complications including blood loss and induced anaphylactoid reactions.
• Monitored cardiovascular changes and plasma histamine concentrations.

Main Results:

• Co-amoxiclav group showed increased plasma histamine post-bleeding.
• While overall histamine release and cardiovascular changes were similar post-resuscitation, the incidence of histamine release reactions differed significantly.
• Cefuroxime/metronidazole group had a significantly lower incidence (2/10) of histamine release reactions compared to controls (8/10) and co-amoxiclav (6/10).

Conclusions:

• The clinic modelling randomised trial (CMRT) is a stable and reproducible model for investigating antibiotic effects.
• Antibiotic prophylaxis can influence the body's response to surgical complications like bleeding and fluid resuscitation.
• Complex animal models are crucial for evaluating new antibiotics before clinical trials.