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Related Experiment Videos

Prophylactic antibiotics in colon surgery.

H T Edmondson, J P Rissing

    Archives of Surgery (Chicago, Ill. : 1960)
    |February 1, 1983
    PubMed
    Summary
    This summary is machine-generated.

    For patients undergoing elective colon surgery, oral erythromycin and neomycin significantly reduced surgical site infections compared to intramuscular cephaloridine. This finding highlights effective antibiotic prophylaxis strategies for preventing wound infections.

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    Area of Science:

    • Surgical Infectious Diseases
    • Clinical Pharmacology
    • Microbiology

    Background:

    • Surgical site infections (SSIs) are a significant complication following colon surgery.
    • Effective antibiotic prophylaxis is crucial for minimizing SSIs.
    • Previous studies have evaluated various antibiotic regimens for abdominal surgery.

    Purpose of the Study:

    • To compare the efficacy of intramuscular cephaloridine versus oral erythromycin base and neomycin sulfate for SSI prevention in elective colon surgery.
    • To assess the impact of antibiotic choice on the incidence of wound infections, particularly those involving Bacteroides fragilis.

    Main Methods:

    • A prospective, randomized trial involving 123 patients undergoing elective colon surgery.
    • Patients received either three 1-g doses of intramuscular cephaloridine or three 1-g doses of oral erythromycin base and neomycin sulfate.

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  • All patients underwent mechanical bowel preparation. Serum and tissue antimicrobial levels were measured.

    • Main Results:

    • The incidence of wound infections was significantly lower in the erythromycin and neomycin group (1.7%) compared to the cephaloridine group (12.3%).
    • Bacteroides fragilis was the predominant organism cultured from infected wounds.
    • Achieved mean serum and tissue concentrations of cephaloridine were substantially higher than those of erythromycin.

    Conclusions:

    • Oral erythromycin and neomycin sulfate demonstrate superior efficacy in preventing surgical site infections after elective colon surgery compared to intramuscular cephaloridine.
    • The findings support the use of oral antibiotic combinations targeting anaerobic bacteria like Bacteroides fragilis for prophylaxis in colon surgery.