Antibiotic Prophylaxis in Colorectal Surgery: Evolving Trends

Peter A Ongom
2013 Journal of Molecular Pharmaceutics & Organic Process Research  
Surgical antibiotic prophylaxis (SAP) is not a method of tissue sterilization, but a precisely timed measure to decrease the microbial load of intraoperative contamination to a level that does not overwhelm the host immune defence. It also does not refer to prevention of Surgical Site Infections (SSIs) following postoperative contamination. The scope of SAP is oriented around elective operations in which skin incisions are closed in the operation room [1]. In light of this, the indications are
more » ... asically clean and clean-contaminated elective surgical procedures. Recommendations issued in clinical practice guidelines likewise, apply to elective surgery. The World Health Organization (WHO) Guidelines for Safe Surgery has one of its objectives as the prevention of SSIs, through the use of SAP and decontamination of the gastrointestinal tract [2] . SSIs are the most common complication following surgery. Patients undergoing clean-contaminated procedures have incidences of 11% for colonic resections [3] , and 3-27% for rectal procedures [4] . Careful follow up of patients in clinical trials reveals rates that are considerably higher [5] . Other septic complications, like enterocutaneous fistulae, complicated intra-abdominal infections, and septicemia, are serious but are much less common. Infectious complication rates range from 30% to 60% without SAP [6] , and are <10% with it.
doi:10.4172/2329-9053.1000109 fatcat:ee7hkdzunfcnvhkfch2lvki2jm