Open AccessVeterans Administration Cooperative Study on Bowel Preparation for Elective Colorectal Operations
Author(s) -
John G. Bartlett,
Robert E. Condon,
Sherwood L. Gorbach,
James S. Clarke,
Ronald Lee Nichols,
Shigeru Ochi
Publication year - 1978
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-197808000-00020
Subject(s) - medicine , bacteroides fragilis , antibiotics , neomycin , anaerobic bacteria , flora (microbiology) , bacteroides , bacteremia , placebo , anaerobic exercise , erythromycin , surgery , bacteria , microbiology and biotechnology , physiology , genetics , alternative medicine , pathology , biology
A ten hospital cooperative study comparing prophylactic oral neomycin and erythromycin base versus placebo demonstrated clinical efficacy of the antibiotics in preventing septic complications following elective colon operations. The present report concerns microbiological studies accomplished during this trial. Cultures of colon contents during surgery showed the antibiotic prep reduced concentrations of both aerobes and anaerobes by approximately 10(5) bacteria/ml. Virtually all major bacterial components of the normal flora were affected. Wound irrigation specimens at the time of closure failed to predict subsequent wound infection, but significantly fewer antibiotic recipients had positive irrigation cultures. Postoperative stool specimens showed that the oral antibiotics did not cause an emergence in resistant forms. Bacteriological studies of postoperative infections indicated that most postoperative infections involved a mixed aerobic-anaerobic flora, and that Bacteroides fragilis accounted for six of eight episodes of bacteremia.