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Results of selective decontamination with oral neomycin and metronidazole for major colorectal surgery in Australia:A cohort study

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Laparoscopic, Endoscopic and Robotic Surgery 2024年第2期7卷 72-78页

作者： James Wei Tatt Toh Devansh Shah Henry Wang Charlotte Kwik Joseph Do Woong Choi Chelsie Leonie Beinke Paul Morris Eleni Baird-Gunning Geoffrey Peter Collins Fiona Gavegan karen shedden Toufic El-Khoury Nimalan Pathma-Nathan Kerry Hitos Department of Colorectal Surgery Westmead HospitalWestmeadNew South WalesAustralia The University of Sydney Westmead HospitalWestmeadNew South WalesAustralia Western Sydney University New South WalesAustralia University of Notre Dame New South WalesAustralia Westmead Research Centre for Evaluation of Surgical Outcomes Westmead HospitalSydneyAustralia

Objective The role of selective decontamination with oral antibiotics(OABs)and mechanical bowel preparation(MBP)prior to elective colorectal surgery is still widely *** objective of this study was to compare the outcomes of selective decontamination with neomycin,metronidazole and MBP compared to those of decontamination with MBP alone or with no *** Selective decontamination with neomycin and metronidazole combined with bowel preparation was introduced prior to elective colorectal surgery as part of an enhanced recovery after surgery program at Westmead Hospital,a major Australian tertiary referral hospital,between June 2017 and January *** between short-term outcomes of OAB+MBP and MBP/no preparation were made using prospectively collected data on length of stay(LOS),readmission,mortality within 30 days,anastomotic leakage(AL),surgical site infection(SSI),urinary tract infection,deep venous thrombosis and/or pulmonary embolism,pneumonia,and ***-up was limited to hospital stays and subsequent presentations within the health district within thirty days of *** Mann-Whitney U test was used to analyse continuous data,and the chi-square test was used for categorical *** and multivariate regression modelling was performed to identify risk factors associated with an increased likelihood of SSI and *** Patients with oral neomycin and metronidazole combined with bowel preparation had reduced superficial SSI(2.7%vs.7.6%,p=0.043)and overall complications(32.7%vs.44.6%,p=0.020),particularly Clavien-Dindo 1 complications(7.3%vs.16.5%,p=0.009).However,the differences in AL(2.7%vs.4.5%,p=0.369)and organ/space SSI(1.3%vs.3.7%,p=0.327)were not statistically *** median LOS(6 d vs.6 d,p=0.370)was not different between the *** Selective decontamination with neomycin and metronidazole reduces the risk of SSIs and overall *** was a trend to toward a lower AL,but this differ

关键词： Neomycin Metronidazole Colorectal surgery Anastomotic leakage Surgical site infection

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