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[Perioperative prophylaxis in elective colorectal surgery].

P Kujath, H P Bruch, E Schmidt

    Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
    |August 1, 1984
    PubMed
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    This study on elective colon surgery found that perioperative antibiotic prophylaxis significantly reduced bacterial growth in the colon. All tested antibiotics were effective, showing low infection rates and high tissue concentrations.

    Area of Science:

    • Surgical Infectious Diseases
    • Pharmacology
    • Gastrointestinal Surgery

    Background:

    • Perioperative antibiotic prophylaxis is crucial in elective colon surgery to prevent surgical site infections.
    • Optimizing antibiotic choice and dosage is essential for efficacy and minimizing resistance.

    Purpose of the Study:

    • To evaluate the efficacy of five different antibiotic regimens in reducing bacterial load and infection rates during elective colon surgery.
    • To determine antibiotic tissue and serum concentrations in relation to minimum inhibitory concentrations (MICs) of common bowel organisms.

    Main Methods:

    • A prospective study involving 100 patients undergoing elective colon surgery with orthograde bowel lavage.
    • Patients were randomized into five groups, each receiving a different antibiotic: cefotaxime, lamoxactam, cefmenoxime, mezlocillin, or piperacillin.

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  • Mucosal biopsies and serum samples were collected for aerobic/anaerobic cultures and antibiotic level determination.

    • Main Results:

    • Significant reduction in colon mucosal bacterial growth was observed across all antibiotic groups.
    • Anaerobic bacteria were identified in only 8% of samples.
    • Achieved tissue antibiotic concentrations were substantially higher than MICs for identified organisms.
    • The overall clinical infection rate was low, at 4%.

    Conclusions:

    • All five evaluated perioperative antibiotic prophylaxis regimens demonstrated high efficacy in elective colon surgery.
    • The antibiotics effectively reduced bacterial load and achieved therapeutic tissue concentrations, leading to low infection rates.
    • These antibiotics can be recommended without reservation for prophylaxis in this surgical setting.