COMPARISON BETWEEN SYSTEMIC AND ORAL ANTIMICROBIAL PROPHYLAXIS IN COLORECTAL SURGERY
COMPARISON BETWEEN SYSTEMIC AND ORAL ANTIMICROBIAL PROPHYLAXIS IN COLORECTAL SURGERY
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结直肠手术中全身和口服抗菌预防的比较
DOI：
10.1016/s0140-6736(79)91373-4
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发表时间：
1979
期刊：
影响因子：
--
通讯作者：
D. Burdon
中科院分区：
文献类型：
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作者：
M. Keighley;Y. Arabi;J. Alexander‐williams;D. Youngs;D. Burdon
在一项前瞻性随机试验中，93名接受择期结肠直肠手术的患者口服或全身给予甲硝唑和卡那霉素的短期预防疗程，系统给予抗菌素的患者中只有3人（6.5%）发生术后脓毒症，而口服预防的患者中有17人（36%）发生术后脓毒症（P< 0.01）。在接受口服抗菌素治疗的患者中，17例感染中有15例是由于手术时结肠中存在卡那霉素耐药菌所致。接受口服治疗的患者中有6例出现金黄色葡萄球菌过度生长。7例患者发生抗生素相关假膜性结肠炎，其中6例接受口服预防。这些结果表明，由于细菌耐药、重复感染和抗生素相关的假膜性结肠炎的风险，结肠手术中应避免口服预防性抗菌药物。手术前系统抗菌预防更安全、更有效。
In a prospective randomised trial in which 93 patients undergoing elective colorectal operations were given a short prophylactic course of metronidazole and kanamycin orally or systemically, postoperative sepsis occurred in only 3 (6·5%) of those given antimicrobials systemically, compared with 17 (36%) of those given oral prophylaxis (P<0·01). 15 of the 17 infections in patients who received antimicrobials orally were due to kanamycinresistant bacteria present in the colon at operation. Bacterial overgrowth ofStaphylococcus aureuswas recorded in 6 of the patients who received oral therapy. Antibiotic-associated pseudomembranous colitis occurred in 7 patients, 6 of whom had received prophylaxis orally. These results indicate that oral administration of prophylactic antimicrobials in colon surgery should be avoided because of the risks of bacterial resistance, superinfection, and antibiotic-associated pseudomembranous colitis. Systemic per-operative antimicrobial prophylaxis is safer and more effective.