Dual Therapy and Triple Therapy of Prophylactic Antibiotics After Elective Colorectal Surgery: A Comparative Study.

Kim, Yoon Seok; Lee, Seung Hyun; Ahn, Byung Kwon; Baek, Sung Uhn

doi:10.3393/jksc.2009.25.1.14

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Original Article
Dual Therapy and Triple Therapy of Prophylactic Antibiotics After Elective Colorectal Surgery: A Comparative Study.: Kim, Yoon Seok , Lee, Seung Hyun , Ahn, Byung Kwon , Baek, Sung Uhn; Journal of the Korean Society of Coloproctology 2009;25(1):14-19
DOI: https://doi.org/10.3393/jksc.2009.25.1.14

Department of Surgery, Kosin University College of Medicine, Busan, Korea. gscrslsh@hanmail

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Abstract

PURPOSE
The use of prophylactic antibiotics is the current standard of care after elective colorectal surgery. The aim of this study was to compare the efficacy of antibiotic prophylaxis with dual antibiotic therapy and triple antibiotic therapy after elective colorectal surgery.
METHODS
We studied consecutive patients underwent elective colorectal surgery from January to June, 2007. Patients of triple-therapy group were administered second cephalosporin, metronidazole, and aminoglycoside for early 3 mo and dual-therapy group were administered second cephalosporin and metronidazole for next 3 mo. The prophylactic antibiotics were administered 2-3 doses for 24 hr after surgery. The surgery for diverticulitis, inflammatory bowel disease, and colon obstruction were excluded. Wound conditions were checked on alternate days during the hospital stay and follow up at least for 30 days after discharge.
RESULTS
Over 6 mo, 110 patients were enrolled (59 dual-therapy group, 51 triple-therapy group). In two group, sex, age, American Society of Anesthesiology score, body mass index, combined diseases, and location of disease were similar. Wound infection rate were 1.7% in dual-therapy group and 2.0% in triple-therapy group (P=1.0). Anastomotic leakage rate were 5.1% in dual-therapy group and 2.0% in triple-therapy group (P=0.622).
CONCLUSION
The addition of aminoglycoside to dual antibiotic therapy, second cephalosporin-metronidazole showed on advantage in prevention of postoperative wound complications. Further studies are required to establish appropriate guideline of antibiotic prophylaxis after elective colorectal surgery.

Keywords: Prophylactic antibiotics;Colorectal surgery;Dual therapy;Triple therapy

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Overview of Antibiotic Use in Korea
Baek-Nam Kim
Infection & Chemotherapy.2012; 44(4): 250. CrossRef
A Prospective, Multicenter, Randomized Trial for Duration of the Prophylactic Antibiotics after Elective Colorectal Surgery: 3 Days versus 5 Days
Ji Won Park, Jae Hwan Oh, Hyo Seong Choi, Sang-Bum Yoo, Young-Ju Choe, Sohee Park, Jung Man Kim, Kang Young Lee, Seung Kook Sohn, Hae Ran Yun, Ho-Kyung Chun, Woo Yong Lee
Journal of the Korean Society of Coloproctology.2010; 26(2): 123. CrossRef
Antimicrobial Prophylaxis Using a 2nd Generation Cephalosporin after Laparoscopic Colorectal Resection: A Randomized Trial of 1-day vs. 3-day
Han Deok Kwak, Dong Jin Choi, Si Uk Woo, Jin Kim, Jun Won Um, Seon Hahn Kim
Journal of the Korean Surgical Society.2010; 78(6): 385. CrossRef
Association Between Prophylactic Antibiotic Use and Surgical Site Infection Based on Quality Assessment Data in Korea
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Journal of Preventive Medicine and Public Health.2010; 43(3): 235. CrossRef

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