Prophylactic oral antimicrobial agents in elective colonic surgery. A controlled trial

Area of Science:

• Surgical Infection Prevention
• Colorectal Surgery
• Microbiology

Background:

• Colonic surgery poses a risk of postoperative wound infections due to resident microflora.
• Anaerobic bacteria are a significant component of the colonic microflora.

Purpose of the Study:

• To evaluate the efficacy of prophylactic oral metronidazole and kanamycin in reducing colonic microflora.
• To assess the impact of this antimicrobial regimen on postoperative wound infection rates.

Main Methods:

• A controlled trial involving 50 patients undergoing elective colonic surgery.
• Intervention group received oral metronidazole and kanamycin.
• Control group received dietary and mechanical preparation only.

Main Results:

• Significant reduction in both aerobic and anaerobic colonic microflora in the treatment group.
• A significant decrease in postoperative wound infections was observed in patients receiving antibiotics.
• One control patient experienced a fatal outcome from Bacteroides septicaemia.

Conclusions:

• Prophylactic oral metronidazole and kanamycin are effective in reducing colonic microflora.
• This regimen significantly lowers the incidence of postoperative wound infections after colonic surgery.
• The studied prophylactic regimen was well-tolerated with no observed toxic side effects.