IMPACT OF ORAL ANTIBIOTIC USE IN PREPARATION FOR COLORECTAL SURGERIES

The use of prophylactic oral antibiotics in colorectal surgeries has been the focus of recent studies, which have demonstrated their impact in reducing rates of infectious complications, such as surgical site infections (SSI) and intestinal fistulas. This study aims to conduct a prospective, randomized, double-blind trial to evaluate the impact of oral antibiotic use on postoperative infectious complications in patients undergoing elective colorectal surgeries. The primary outcome being studied is the influence of oral antibiotics on surgical site infection rates, while the secondary outcome focuses on the incidence of intestinal fistulas. The study is ongoing, and preliminary results are presented here. Patients were divided into two groups: the test group, in which patients received oral neomycin and metronidazole on the day before surgery, and the control group, in which patients received a placebo the day before surgery. Both groups received standard intravenous antibiotic prophylaxis. Colon preparation was performed according to institutional protocols, regardless of group assignment. No mechanical bowel preparation was performed for right ileocolectomy or abdominoperineal resection. For surgeries involving the left colon, upper rectum, or total colectomy, preparation included glycerin enemas. For rectosigmoidectomy with total mesorectal excision, mechanical bowel preparation was performed. A total of 44 eligible patients were included in the study, with 21 in the test group and 23 in the control group. The groups were comparable, differing only in median age, which was 55 years in the test group and 67 years in the control group. For the primary outcome, the control group exhibited a higher rate of infectious complications (19% vs. 43.5%; p-value: 0.082). For the secondary outcome, the groups were similar (5.6% vs. 11.8%; p-value: 0.512). The results for surgical site infections are notable, and while there is no statistically significant difference, this may be attributed to the small sample size. The findings thus far are encouraging and support further studies on the use of oral antibiotics in preoperative preparation for colorectal surgeries.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025