scholarly journals Clinical outcomes following mechanical plus oral antibiotic bowel preparation versus oral antibiotics alone in patients undergoing colorectal surgery

BJS Open ◽  
2018 ◽  
Vol 2 (4) ◽  
pp. 238-245 ◽  
Author(s):  
S. R. Kaslow ◽  
F. Gani ◽  
H. N. Alshaikh ◽  
J. K. Canner
Keyword(s):  
Colorectal Surgery ◽  
Clinical Outcomes ◽  
Bowel Preparation ◽  
Oral Antibiotic ◽  
Oral Antibiotics

scholarly journals Oral antibiotics prior to colorectal surgery: Do they have to be combined with mechanical bowel preparation?

2019 ◽  
Vol 40 (8) ◽  
pp. 922-927 ◽  
Author(s):  
Tessa Mulder ◽  
Jan A.J.W. Kluytmans
Keyword(s):  
Colorectal Surgery ◽  
Bowel Preparation ◽  
Observational Studies ◽  
Meta Analysis ◽  
Mechanical Bowel Preparation ◽  
Oral Antibiotic ◽  
Oral Antibiotics ◽  
Risk Infection

AbstractTo reduce the of risk infection after colorectal surgery, oral antibiotic preparation (OAP) and mechanical bowel preparation (MBP) can be applied. Whether OAP can be used without MBP is unclear. A meta-analysis of observational studies demonstrated comparable effectiveness of OAP with and without MBP regarding SSI risk.

scholarly journals Mechanical bowel preparation and oral antibiotics versus mechanical bowel preparation only prior rectal surgery (MOBILE2): a multicentre, double-blinded, randomised controlled trial—study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e051269
Author(s):  
Laura Koskenvuo ◽  
Pipsa Lunkka ◽  
Pirita Varpe ◽  
Marja Hyöty ◽  
Reetta Satokari ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Bowel Preparation ◽  
Controlled Trial ◽  
Rectal Surgery ◽  
Mechanical Bowel Preparation ◽  
Oral Antibiotic ◽  
Oral Antibiotics ◽  
Number Of Patients ◽  
Randomised Controlled ◽  
Double Blinded

IntroductionMechanical bowel preparation (MBP) prior to rectal surgery is widely used. Based on retrospective data many guidelines recommend mechanical and oral antibiotic bowel preparation (MOABP) to reduce postoperative complications and specifically surgical site infections (SSIs). The primary aim of this study is to examine whether MOABP reduces complications of rectal surgery.Methods and analysisThe MOBILE2 (Mechanical Bowel Preparation and Oral Antibiotics vs Mechanical Bowel Preparation Only Prior Rectal Surgery) trial is a multicentre, double-blinded, parallel group, superiority, randomised controlled trial comparing MOABP to MBP among patients scheduled for rectal surgery with colorectal or coloanal anastomosis. The patients randomised to the MOABP group receive 1 g neomycin and 1 g metronidazole two times on a day prior to surgery and patients randomised to the MBP group receive identical placebo. Based on power calculations, 604 patients will be enrolled in the study. The primary outcome is Comprehensive Complication Index within 30 days after surgery. Secondary outcomes are SSIs within 30 days after surgery, the number and classification of anastomosis dehiscences, the length of hospital stay, mortality within 90 days after surgery and the number of patients who received adjuvant treatment if needed. Tertiary outcomes are overall survival, disease-specific survival, recurrence-free survival and difference in quality-of-life before and 1 year after surgery. In addition, the microbiota differences in colon mucosa are analysed.Ethics and disseminationThe Ethics Committee of Helsinki University Hospital approved the study. The findings will be disseminated in peer-reviewed academic journals.Trial registration numberNCT04281667.

scholarly journals Relationship between Adherence to Oral Antibiotics and Postdischarge Clinical Outcomes among Patients Hospitalized with Staphylococcus aureus Skin Infections

2016 ◽  
Vol 60 (5) ◽  
pp. 2941-2948 ◽  
Author(s):  
Samantha J. Eells ◽  
Megan Nguyen ◽  
Jina Jung ◽  
Raul Macias-Gil ◽  
Larissa May ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Antibiotic Therapy ◽  
Clinical Response ◽  
Clinical Outcomes ◽  
Hospital Discharge ◽  
Oral Antibiotic ◽  
Soft Tissue Infections ◽  
Oral Antibiotics ◽  
Oral Antibiotic Therapy

ABSTRACTSkin and soft tissue infections are common and frequently recur. Poor adherence to antibiotic therapy may lead to suboptimal clinical outcomes. However, adherence to oral antibiotic therapy for skin and soft tissue infections and its relationship to clinical outcomes have not been examined. We enrolled adult patients hospitalized with uncomplicated skin and soft tissue infections caused byStaphylococcus aureuswho were being discharged with oral antibiotics to complete therapy. We fit the participants' pill bottles with an electronic bottle cap that recorded each pill bottle opening, administered an in-person standardized questionnaire at enrollment, 14 days, and 30 days, and reviewed the participants' medical records to determine outcomes. Our primary outcome was poor clinical response, defined as a change in antibiotic therapy, new incision-and-drainage procedure, or new skin infection within 30 days of hospital discharge. Of our 188 participants, 87 had complete data available for analysis. Among these participants, 40 (46%) had a poor clinical response at 30 days. The mean electronically measured adherence to antibiotic therapy was significantly different than the self-reported adherence (57% versus 96%;P< 0.0001). In a multivariable model, poor clinical response at 30 days was associated with patients having lower adherence, being nondiabetic, and reporting a lack of illicit drug use within the previous 12 months (P< 0.05). In conclusion, we found that patient adherence to oral antibiotic therapy for a skin and soft tissue infection after hospital discharge was low (57%) and associated with poor clinical outcome. Patients commonly overstate their medication adherence, which may make identification of patients at risk for nonadherence and poor outcomes challenging. Further studies are needed to improve postdischarge antibiotic adherence after skin and soft tissue infections.

scholarly journals Another Brick in the Wall of an Ongoing Discussion– Reduction of Anastomotic Leaks after Colorectal Resection by Preoperative Mechanical Bowel Preparation in Combination with Oral and Parenteral Antibiotics?–A Clinical Retrospective Single Center Study

2021 ◽  
Vol 8 (5) ◽  
Author(s):  
Safia O ◽  
◽  
Kuebler S ◽  
Mall JW ◽  
Tallbot SR ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Length Of Stay ◽  
Bowel Preparation ◽  
Elective Surgery ◽  
Mechanical Bowel Preparation ◽  
Oral Antibiotic ◽  
Single Center ◽  
Elective Colorectal Surgery ◽  
Single Center Study ◽  
Center Study

Background: In colorectal surgery, postoperative Anastomotic Leak (AL) is a serious complication. Besides the surgeon`s experience, bowel preparation may have an impact on AL, but the published data are still inconclusive. The purpose of this retrospective single center study was to investigate the role of preoperative Mechanical Bowel Preparation (MBP) in combination with Oral Antibiotic Bowel Preparation (OBP) and parenteral antibiotics in a certified highvolume colorectal center. Methods: In the period of January 2017 to December 2019, all colon and rectal surgeries were recorded and separated into emergency and elective surgeries. Patients in the elective surgery group were further divided into two groups: patients with Bowel Preparation (BP) and patients without BP and were evaluated concerning to AL, postoperative hospital length of stay and mortality. Results: Between 2017 to 2019, 625 patients underwent colorectal surgery. 262 patients had emergency operations and were therefore excluded from the study. 363 patients underwent colorectal elective surgery (197men, 166 women). 44.0% received Combined Bowel Preparation (CBP), 46.8% received no BP, 3.3% received OBP only, 4.1% received MBP only, and for 1.1% nothing was documented. CBP was not only associated with a reduction in the rate of AL (P=0.038) (14.1% vs. 4.4%), but also with reduction in mortality (P=0.032) (7.6% vs. 1.2%) and length of stay (P=0.016) (14 vs. 11 days). Conclusion: Our retrospective data showed a significant impact of preoperative intestinal preparation with MBP in combination with OBP and parenteral antibiotics on AL, length of stay and mortality. Therefore we strongly recommend the use of this regimen of preoperative BP in elective colorectal surgery.

scholarly journals EP.TH.965Use of Oral Antibiotics as Adjunct to Systemic Antibiotics and Mechanical Bowel Preparation for Left Sided Colorectal Surgery. It is the time to trust the best available evidence and change the practice

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Shahin Hajibandeh ◽  
Shahab Hajibandeh ◽  
Christopher Thompson ◽  
Vijay Thumbe ◽  
Andrew Torrance ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Bowel Preparation ◽  
Mechanical Bowel Preparation ◽  
Surgical Site Infections ◽  
Oral Antibiotics ◽  
Intravenous Antibiotics ◽  
Clinically Significant ◽  
The Uk ◽  
Systemic Antibiotics

Abstract Aims To prospectively evaluate the clinical efficacy of oral antibiotics as an adjunct to intravenous antibiotics and mechanical bowel preparation (MBP) in patients undergoing left sided colorectal surgery. Methods All participants aged 18 years or older and of any gender undergoing an elective open or laparoscopic left sided colorectal resection for benign or malignant colorectal pathologies were considered. The intervention of interest was oral neomycin 1g every 4 hours combined with oral metronidazole 400mg every 8 hours from 24 hours before the proposed surgery. Surgical site infections (SSIs), anastomotic leak, paralytic ileus, need for intervention, and mortality were the evaluated outcome parameters. Results Forty-two consecutive patients received oral antibiotics as an adjunct to intravenous antibiotics and MBP before left sided colorectal surgery. The mean age was 58.8 ± 11.5. There were 23 males (54.8%) and 19 females (45.2%). Use of oral antibiotics was associated with SSI infection rate of 2.4% (1 patient). The rates of clinically significant and non-significant anastomotic leak were 0% and 2.9%, respectively. Moreover, postoperative ileus happened in 11.9% of patients. Furthermore, there was no mortality or need for re-intervention. Conclusions Use of oral antibiotics as an adjunct to intravenous antibiotics and MBP in patients undergoing left-sided colorectal surgery was associated with a surprisingly low rate of SSIs and no significant anastomotic leak. It is time to trust the best available evidence and incorporate the use of oral antibiotics as an adjunct to intravenous antibiotics and MBP in colorectal surgery protocols in the UK hospitals.

Usefulness of Preoperative Mechanical Bowel Preparation in Patients with Colon Cancer who Undergo Elective Surgery: A Prospective Randomized Trial Using Oral Antibiotics

2019 ◽  
Vol 37 (3) ◽  
pp. 192-198 ◽  
Author(s):  
Toshiyuki Suzuki ◽  
Sotaro Sadahiro ◽  
Akira Tanaka ◽  
Kazutake Okada ◽  
Gota Saito ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Bowel Preparation ◽  
Elective Surgery ◽  
Mechanical Bowel Preparation ◽  
Infectious Complications ◽  
Oral Antibiotic ◽  
Oral Antibiotics ◽  
Intravenous Antibiotics ◽  
Colon Cancer Surgery ◽  
To Receive

Background: To prevent surgical site infection (SSI) in colorectal surgery, the combination of mechanical bowel preparation (MBP), oral antibiotic bowel preparation (OABP), and the intravenous antibiotics have been proposed as standard treatment. We conducted an RCT comparing the incidence of SSI between MBP + OABP and OABP alone after receiving a single dose of intravenous antibiotics. Methods: The study group comprised 254 patients who underwent elective surgery for colon cancer. Patients were randomly assigned to receive MBP + OABP and intravenous antibiotics (MBP + OABP group) or to receive OABP and intravenous antibiotics (OABP alone group). Results: Overall, 125 patients in MBP + OABP group and 126 patients in OABP alone group were eligible. Incisional SSI occurred in 3 patients (2.4%) in MBP + OABP group, and 8 patients (6.3%) in the OABP-alone group. Organ/space SSI developed in 0 patients (0%) and in 4 patients (3.2%) in each group respectively. The OABP-alone group was thus not shown to be noninferior to the MBP + OABP group in the incidences of incisional SSI or organ/space SSI. Other infectious complications developed in 7 patients (5.6%) and in 6 patients (4.8%) in each group, indicating the non-inferiority of OABP alone to MBP + OABP. Conclusions: MBP combined with oral antibiotics and intravenous antibiotics remains standard in elective colon cancer surgery.

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