Veterans Administration Cooperative study on bowel preparation for elective colorectal operations: Impact of oral antibiotic regimen on colonic flora, wound irrigation cultures and bacteriology of septic complications

J. G. Bartlett, R. E. Condon, S. L. Gorbach, J. S. Clarke, R. L. Nichols, S. Ochi

Research output: Contribution to journalArticle

Abstract

A ten hospital cooperative study comparing prophylactic oral neomycin and erythromycin base versus placebo demonstrated the 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 preparation reduced concentrations of both aerobes and anaerobes by approximately 105 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.

Original languageEnglish (US)
Pages (from-to)249-254
Number of pages6
JournalUnknown Journal
Volume188
Issue number2
DOIs
StatePublished - Jan 1 1978
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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