Antibiotic Prophylaxis in Colorectal Surgery

Czech version

Authors: R. Hrivnák ¹; I. Hanke ¹; M. Hanslianová ²; Z. Kala ¹; A. Ševčíková ²
Authors‘ workplace: Chirurgická klinika FN Brno-Bohunice, LF MU v Brně, přednosta: prof. MUDr. Zdeněk Kala, CSc. ¹; Oddělení klinické mikrobiologie FN Brno, primářka: MUDr. Alena Ševčíková ²
Published in: Rozhl. Chir., 2009, roč. 88, č. 6, s. 330-333.
Category: Monothematic special - Original

Overview

Objective:
Antibiotic (ATB) prophylaxis is generaly recommended in surgery. There is an important role in colorectal surgery especially. Colorectal surgery is associated with a particularly high risk of post-operative infection because of contamination of the wound with faecal bacteria. ATB prophylaxis decreases surgical wound infection, morbidity and mortality as well. Morbidity and mortality are associated with longer hospital stays and increased costs of care.

Method:
At surgical department of Faculty hospital Brno, during March–June 2008 an 88 patients were operated because of different diagnoses in colorectum. Both an emergent and schedule operations were made. Type of ATBs, time of aplication before operation, reaplication after operation and surgical site infection (SSI), in - hospital stay were followed up prospectively. SSI were divided into superficial, deep and intraabdominal. Data were analyse statistically.

Results:
The most used combination of ATBs, almost in 91%, were Cefazoline and Metronidazole. In 50% were time of aplication till 20 minutes before incision. Only in 17% were time of aplication in interval 20–30 minutes before incision, which is recommended. We noticed 25 SSI. We prove that patients with SSI has almost two-times longer in-hospital stay. Enterococcus and enterobacterias were the most common etiological agens.

Conclusion:
ATB prophylaxis is indicated in colorectal surgery. It has to be aplicated in correct dose and right time before operation to decrease SSI.

Key words:
antibiotic prophylaxis – surgical site infection – in-hospital stay

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