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[Results of enteral antibiotic preparation prior to colon surgery]
Insights
Comparing two antibiotic regimens for colon surgery preparation, Cephaloridin-Colistinsulfate achieved significantly higher rates of intestinal asepsis (42.4%) than Neomycin-Bacitracin (13.5%). Cost and bacterial reduction are key factors for selection.
Area of Science:
- Gastroenterology
- Surgical Infectious Diseases
- Microbiology
Background:
- Preoperative bowel preparation is crucial for reducing surgical site infections in colon operations.
- The fecal flora in most patients undergoing colon surgery is often abnormal prior to preparation.
- Antibiotic prophylaxis aims to minimize bacterial load in the gut.
Purpose of the Study:
- To compare the efficacy of two different antibiotic combinations for preoperative intestinal preparation in colon surgery patients.
- To evaluate the impact of antibiotic treatment on fecal flora and achieve intestinal asepsis.
- To provide criteria for selecting appropriate antibiotic regimens based on cost and bacterial reduction.
Main Methods:
- A prospective study involving 108 patients undergoing colon operations.
- Patients received four days of dietary and mechanical bowel preparation.
- Two antibiotic combinations were administered based on date of birth: Neomycin-Bacitracin (Group I) and Cephaloridin-Colistinsulfate (Group II).
- Bacteriologic stool studies were performed before, during, and after antibiotic treatment. Intestinal mucous membrane samples were analyzed in 70 patients.
Main Results:
- Antibiotic treatment significantly reduced bacterial counts in stool samples.
- Group II (Cephaloridin-Colistinsulfate) achieved full intestinal asepsis in 42.4% of patients.
- Group I (Neomycin-Bacitracin) achieved full intestinal asepsis in only 13.5% of patients.
- Abnormal fecal flora was prevalent before antibiotic administration.
Conclusions:
- Cephaloridin-Colistinsulfate is more effective than Neomycin-Bacitracin in achieving preoperative intestinal asepsis for colon surgery.
- The choice of antibiotic preparation should consider both the cost of the agents and their effectiveness in reducing preoperative intestinal bacteria.
- Optimizing antibiotic selection can improve surgical outcomes by enhancing bacterial reduction.
Abstract:
Of the 108 patients explored, all received four days preoperatively dietary and mechanical preparation and were given one of the two antibiotic combinations according to their date of birth (58 patients, group I--Neomycin-Bacitracin; 50 patients, group II--Cephaloridin-Colistinsulfate). Bacteriologic studies of stools from the day before beginning of preparation, preoperatively and from the day of operation (intestinal mucous membrane of 70 patients) revealed that the fecal flora of the majority of the patients was abnormal. After antibiotic treatment the bacteriologic studies of stools showed a significant reduction of bacteria. In group II, full asepsis was reached in 42.4% of patients, in group I, in only 13.5%. The price of antibiotics and the preoperative intestinal bacteria should be used as criteria in choosing the preparation for colon operations.