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International Journal of Colorectal Disease

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Open Access 01-09-2021 | Metronidazole | Original Article

Mechanical plus oral bowel preparation with paromomycin and metronidazole reduces infectious complications in elective colorectal surgery: a matched case-control study

Authors: Matthias Mehdorn, Christoph Lübbert, Iris F. Chaberny, Ines Gockel, Boris Jansen-Winkeln

Published in: International Journal of Colorectal Disease | Issue 9/2021

Abstract

Purpose

Infectious complications are as high as 30% in elective colorectal surgery. In recent years, several studies have discussed the topic of preoperative bowel decontamination prior to colorectal surgery in order to reduce postoperative infectious complications and have found significant effects of oral antibiotic administration with a large variety of drugs used. No study has evaluated the combination of oral paromomycin and metronidazole in this context.

Methods

We performed a prospective single-center study with a matched-pair retrospective cohort to evaluate postoperative infectious complications (superficial site infections, organ space abscess, anastomotic leakage) in elective colorectal surgery.

Patients

A total of 120 patients were available for study inclusion; 101 gave informed consent and were included. A total of 92 patients were matched and subsequently analyzed. We could show a reduction in overall infectious complications in the intervention group (15.2% vs 30.8%, p = 0.018; odds ratio 0.333, 95% CI 0.142–0.784) as well as a reduction in superficial surgical site infections (8.7 vs 19.6%, p = 0.041, OR 0.333, 95% CI 0.121–0.917). The frequency of the other infectious complications such as intraabdominal abscesses and anastomotic leakage showed a tendency towards decreased frequencies in the intervention group (OR 0.714, 95% CI 0.235–2.169 and OR 0.571; 95% CI 0.167–1.952, respectively). Finally, the oral antibiotic administration led to an almost significantly reduced length of stay (12.24 days vs 15.25 days; p = 0.057).

Conclusions

Oral paromomycin and metronidazole with intravenous ertapenem effectively reduce infectious complications in elective colorectal surgery.

Trial registration

The study was registered at Clinicaltrials.gov (NCT03759886) December 17, 2018

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Title: Mechanical plus oral bowel preparation with paromomycin and metronidazole reduces infectious complications in elective colorectal surgery: a matched case-control study
Authors: Matthias Mehdorn
Christoph Lübbert
Iris F. Chaberny
Ines Gockel
Boris Jansen-Winkeln
Publication date: 01-09-2021
Publisher: Springer Berlin Heidelberg
Keywords: Metronidazole
Antibiotic
Ertapenem
Published in: International Journal of Colorectal Disease / Issue 9/2021
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-021-03931-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Mechanical plus oral bowel preparation with paromomycin and metronidazole reduces infectious complications in elective colorectal surgery: a matched case-control study

Abstract

Purpose

Methods

Patients

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Patients

Conclusions

Trial registration

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