Whether to administer purgative cleansing and oral antibiotics before colon surgery as a method to prevent postoperative infections, once standard of care, is now being considered unnecessary with today’s advancements of care. A new study questions the efficacy of this bowel preparation approach with a prospective randomized trial.
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References
Paulson, E. C., Thompson, E. & Mahmoud, N. Surgical site infection and colorectal surgical procedures: a prospective analysis of risk factors. Surg. Infect. 18, 520–526 (2017).
Rosenberg, I. L. et al. Preparation of the intestine in patients undergoing major large-bowel surgery, mainly for neoplasms of the colon and rectum. Br. J. Surg. 58, 266–269 (1971).
Zelhart, M. D. et al. Preoperative antibiotic colon preparation: have we had the answer all along? J. Am. Coll. Surg. 219, 1070–1077 (2014).
McChesney, S. L. et al. Current U.S. pre-operative bowel preparation trends: a 2018 survey of the American Society of Colon and Rectal Surgeons members. Surg. Infect. https://doi.org/10.1089/sur.2019.125 (2019).
Battersby, C. L. F., Battersby, N. J., Slade, D. A. J., Soop, M. & Walsh, C. J. Preoperative mechanical and oral antibiotic bowel preparation to reduce infectious complications of colorectal surgery - the need for updated guidelines. J. Hosp. Infect. 101, 295–299 (2019).
Koskenvuo, L. et al. Mechanical and oral antibiotic bowel preparation versus no bowel preparation for elective colectomy (MOBILE): a multicentre, randomised, parallel, single-blinded trial. Lancet 394, 840–848 (2019).
Nichols, R. L., Choe, E. U. & Weldon, C. B. Mechanical and antibacterial bowel preparation in colon and rectal surgery. Chemotherapy 51 (Suppl. 1), 115–121 (2005).
Teillant, A. et al. Potential burden of antibiotic resistance on surgery and cancer chemotherapy antibiotic prophylaxis in the USA: a literature review and modelling study. Lancet Infect. dis. 15, 1429–1437 (2015).
Gilbert, J. A. et al. Microbiome-wide association studies link dynamic microbial consortia to disease. Nature 535, 94–103 (2016).
Alverdy, J. C. et al. Preparing the bowel for surgery: learning from the past and planning for the future. J. Am. Coll. Surg. 225, 324–332 (2017).
Acknowledgements
J.C.A. acknowledges support from NIHR Public Health Research Programme grant R01- GM062344-18.
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Alverdy, J.C., Shogan, B.D. Preparing the bowel for surgery: rethinking the strategy. Nat Rev Gastroenterol Hepatol 16, 708–709 (2019). https://doi.org/10.1038/s41575-019-0214-y
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DOI: https://doi.org/10.1038/s41575-019-0214-y
