The role of oral antibiotics prophylaxis in prevention of surgical site infection in colorectal surgery

Michalis Koullouros, Nadir Khan, Emad H. Aly

Research output: Contribution to journalReview article

21 Citations (Scopus)

Abstract

BACKGROUND: Surgical site infection (SSI) continues to be a challenge in colorectal surgery. Over the years, various modalities have been used in an attempt to reduce SSI risk in elective colorectal surgery, which include mechanical bowel preparation before surgery, oral antibiotics and intravenous antibiotic prophylaxis at induction of surgery. Even though IV antibiotics have become standard practice, there has been a debate on the exact role of oral antibiotics.

AIM: The primary aim was to identify the role of oral antibiotics in reduction of SSI in elective colorectal surgery. The secondary aim was to explore any potential benefit in the use of mechanical bowel preparation (MBP) in relation to SSI in elective colorectal surgery.

METHODS: Medline, Embase and the Cochrane Library were searched. Any randomised controlled trials (RCTs) or cohort studies after 1980, which investigated the effectiveness of oral antibiotic prophylaxis and/or MBP in preventing SSIs in elective colorectal surgery were included.

RESULTS: Twenty-three RCTs and eight cohorts were included. The results indicate a statistically significant advantage in preventing SSIs with the combined usage of oral and systemic antibiotic prophylaxis. Furthermore, our analysis of the cohort studies shows no benefits in the use of MBP in prevention of SSIs.

CONCLUSIONS: The addition of oral antibiotics to systemic antibiotics could potentially reduce the risk of SSIs in elective colorectal surgery. Additionally, MBP does not seem to provide a clear benefit with regard to SSI prevention.

Original languageEnglish
Pages (from-to)1-18
Number of pages18
JournalInternational Journal of Colorectal Disease
Volume32
Issue number1
Early online date24 Oct 2016
DOIs
Publication statusPublished - Jan 2017

Keywords

  • Antibiotics
  • Prophylaxis
  • Wound site infection
  • Colorectal surgery

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