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Cecal Ligation Puncture Procedure
11:53

Cecal Ligation Puncture Procedure

Published on: May 7, 2011

Cimetidine and the potential risk of postoperative sepsis

T J Muscroft, D Youngs, D W Burdon

    The British Journal of Surgery
    |August 1, 1981
    PubMed

    Insights

    Cimetidine use in duodenal ulcer patients increases stomach bacteria, raising postoperative sepsis risk. Patients may need antibiotics or drug withdrawal before surgery if stomach pH is 4 or higher.

    Area of Science:

    • Gastroenterology
    • Microbiology
    • Pharmacology

    Background:

    • Cimetidine is a common treatment for duodenal ulcers.
    • The drug reduces stomach acid (hypochlorhydria).
    • Hypochlorhydria can lead to bacterial overgrowth in the stomach.

    Purpose of the Study:

    • To investigate the impact of cimetidine on gastric microflora.
    • To compare bacterial levels in cimetidine-treated patients versus untreated patients.
    • To assess the risk of postoperative sepsis in patients taking cimetidine.

    Main Methods:

    • Gastric aspirates were collected from fasting patients receiving cimetidine.
    • Bacterial presence in aspirates was analyzed 2-4 hours and 12-13 hours after the last dose.
    • Results were compared to a control group of untreated patients.

    Main Results:

    • 75% of patients on 1g daily cimetidine had bacteria 2-4 hours post-dose.
    • 34% of patients on 400mg at night still had bacteria 12-13 hours later.
    • Cimetidine-treated patients showed increased gastric bacterial proliferation.

    Conclusions:

    • Cimetidine use is associated with increased gastric bacteria.
    • Patients on cimetidine may face a higher risk of postoperative sepsis.
    • Consider withdrawing cimetidine before surgery or providing antibiotic cover for gastric pH >= 4.

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