Newswise — In the September 2017 issue of Diseases of the Colon & Rectum, surgeons from the Mayo Clinic present postoperative infection data on nearly 1000 patients undergoing colorectal surgery. These surgeons analyzed different methods of antibiotic dosing before surgery and answered the question: Will use of fewer antibiotics for a shorter duration result in a similar rate of wound infections as antibiotics used for a longer duration? 

The authors of this very large study found that when patients were provided only a single dose of antibiotic before surgery, with re-dosing if the operation lasted longer, compared to patients given antibiotics for 24 hours postoperatively, infection rates were identical.  Both laparoscopic and traditional operations were included in the study. There was no difference in the infection rate whether operations were performed laparoscopically or by traditional approach (4% with the laparoscopic approach and 6% infection rate with the traditional approach). A simple, low-cost antibiotic combination was used before surgery to reduce the risk of postoperative infections. 

Colon resections are commonly performed for a variety of conditions, including colorectal cancer, diverticulitis, inflammatory conditions such as Crohn’s disease and ulcerative colitis, as well as for colon polyps and other disorders. Colon surgery can be associated with an infection rate higher than 10% because of the high bacterial content of the colon.  Infections after this type of surgery are much more common than after other operations such as gallbladder or weight loss surgery.  The authors have shown that by careful selection of safe, low-cost antibiotics, excellent results can be achieved.  By using very safe antibiotics that are given as few times as necessary, they reduced the risk of development of resistant bacteria.  Resistant bacteria are currently a very big problem in healthcare; most everyone is familiar with the term methicillin-resistant Staphylococcus aureus, also known as MRSA.  In addition to this, antibiotic use can also lead to other problems such as infection with the bacteria Clostridium difficile, also known as C. difficile, which is currently one of the most common hospital-acquired infections.  Colorectal surgeons continue in their efforts to make surgery safer for patients.

David W. Larson, an author of the study, said: “Preoperative antibiotic dosing with intraoperative re-dosing is an opportunity for surgeons to maximize quality while minimizing SSI and unnecessary antibiotic risk.”

Authors: Mark Dornfeld, Jenna K. Lovely, Marianne Huebner, David W. Larson

Title of Article: Surgical Site Infection in Colorectal Surgery: A Study in Antibiotic Duration

A prepublication copy is available on request.  Please email Margaret Abby, Managing Editor, Diseases of the Colon and Rectum at dcrjournalmanagingeditor@gmail.com

For any requests for interviews, please email Sharon Theimer at theimer.sharon@mayo.edu and to the main media relations inbox at newsbureau@mayo.edu 

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