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Randomized Controlled Trial
. 2021 Feb;36(2):323-330.
doi: 10.1007/s00384-020-03746-0. Epub 2020 Sep 28.

Impact of oral antibiotic prophylaxis on surgical site infection after rectal surgery: results of randomized trial

Evgeny Rybakov  1 , Marat Nagudov  2 , Marina Sukhina  2 , Yuri Shelygin  2   3
Affiliations
Randomized Controlled Trial

Impact of oral antibiotic prophylaxis on surgical site infection after rectal surgery: results of randomized trial

Evgeny Rybakov et al. Int J Colorectal Dis. 2021 Feb.

Abstract

Aim: To evaluate the impact of oral antibiotic prophylaxis on surgical site infection (SSI) rate after rectal surgery.

Methods: It was a single-center 1:1 randomized controlled open parallel trial (registration number NCT03436719). The patients undergoing rectal resection for benign and malignant tumors were assigned randomly to two groups: the oral plus intravenous (IV) antibiotic prophylaxis (AP) and the IV antibiotic prophylaxis only. The primary endpoint was the overall rate of SSI.

Results: Between November 2017 and December 2018, 116 (male-55, the mean age-64 years) patients were enrolled into the trial. Of them, 57 had oral erythromycin 500 mg + metronidazole 500 mg a day before surgery and 1,000 mg of cephalosporin IV 30-90 min before operation. In the other group, 59 patients had the same IV antibiotics only. The incidence of SSIs was 22% (13/59) and 3.5% (2/57) correspondingly (р = 0.002). The statistically significant difference was detected for superficial SSI 0 (0%) vs. 5 (8.5%) (p = 0.03) and organ/space SSI 2 (3.5%) vs. 9 (15.3%) (p = 0.03), respectively. A multivariate analysis of risk factors of SSI identified two independent ones: bacterial contamination of the pelvic cavity ≥ 105 CFU at the end of surgery OR 17.9, 95% CI 2.1-150.0 (p = 0.008) and oral antimicrobial prophylaxis OR 0.2, 95% CI 0.03-0.8 (p = 0.02).

Conclusion: Oral-parenteral AP significantly reduced the risk of SSI following elective rectal surgery. Bacterial contamination of the pelvic cavity ≥ 105 CFU at the end of surgery and oral antimicrobial prophylaxis were independent risk factors of SSI.

Keywords: Colorectal surgery; Mechanical bowel preparation; Oral antibiotics; Surgical site infection.

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References

    1. Gomila A, Carratalà J, Camprubí D et al (2017) Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery. Antimicrob Resist Infect Control 6:40. https://doi.org/10.1186/s13756-017-0198-8 - DOI - PubMed - PMC
    1. Hübner M, Diana M, Zanetti G, Eisenring MC, Demartines N, Troillet N (2011) Surgical site infections in colon surgery: the patient, the procedure, the hospital, and the surgeon. Arch Surg 146(11):1240–1245. https://doi.org/10.1001/archsurg.2011.176 - DOI - PubMed
    1. European Center for Disease Prevention and Control. Point prevalence survey of health care associated infections and antimicrobial use in European acute care hospitals 2011-2012. https://www.ecdc.europa.eu/sites/portal/files/media/en/publications/Publ... https://doi.org/10.2900/86011
    1. Baum ML, Anish DS, Chalmers TC, Sacks HS, Smith H Jr, Fagerstrom RM (1981) A survey of clinical trials of antibiotic prophylaxis in colon surgery: evidence against further use of no-treatment controls. N Engl J Med 305:795–799. https://doi.org/10.1056/NEJM198110013051404 - DOI - PubMed
    1. Matheson DM, Arabi Y, Baxter-Smith D, Alexander-Williams J, Keighley MR (1978) Randomized multicentre trial of oral bowel preparation and antimicrobials for elective colorectal operations. Br J Surg 65:597–600. https://doi.org/10.1002/bjs.1800650902 - DOI - PubMed

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