[Antibiotic preparation in operations on the large intestine. Experimental study]

Area of Science:

• Surgical prophylaxis
• Pharmacological barriers
• Anaerobic bacterial infection control

Background:

• Colon surgery carries a risk of anaerobic bacterial spread and subsequent septic complications.
• Established protocols, like the erythromycin + neomycin (E.N.) combination, aim to mitigate this risk.
• Further strategies are explored to enhance the pharmacological barrier against anaerobic bacteria.

Purpose of the Study:

• To evaluate the potential benefit of adding lincomycin to the standard erythromycin + neomycin regimen for colon surgery.
• To assess if this enhanced regimen further reduces the incidence of septic complications.
• To investigate the efficacy of a triple-drug prophylactic approach (erythromycin, neomycin, and lincomycin) in preventing anaerobic bacterial infections.

Main Methods:

• A controlled study involving two patient groups (n=15 each) undergoing colon surgery.
• Patients were randomly assigned to either the E.N. protocol or an E.N.L. (erythromycin, neomycin, lincomycin) protocol.
• Lincomycin (600 mg) was administered intravenously one hour prior to surgery in the E.N.L. group.

Main Results:

• A total of six septic complications were observed across both groups.
• Five complications occurred in the E.N. group, while only one occurred in the E.N.L. group.
• The observed difference in complication rates between the E.N. and E.N.L. groups was not statistically significant due to the small sample size.

Conclusions:

• The addition of lincomycin to erythromycin and neomycin showed a trend towards reducing septic complications in colon surgery.
• However, the current study's limited number of patients precludes definitive conclusions regarding the significance of this finding.
• Larger controlled trials are warranted to confirm the efficacy of the E.N.L. regimen as an enhanced prophylactic strategy.