Role of Oral Antibiotics in Elective Colorectal Surgery

Introduction: Surgical site infection (SSI) is a major burden for patients who are posted for elective colorectal surgery, also there is significant increase to the cost of health care.it is a major cause of morbidity after surgery and is associated with increased hospital stay, readmissions, costs, and sometimes mortality. Surgical site infections are very high in colorectal surgery and are estimated to vary from 15% to 30% of patients undergoing colorectal surgery. For colorectal surgeries, orally administered antibiotics can be used in addition to the intravenous antibiotic prophylaxis. Material and Methods: A total of 46 patients were included in the study who were posted for elective colorectal surgery. Patients who start with the 3-day intervention period but for whom surgery is cancelled or postponed for more than 7 days, will not be evaluable for analysis. After enrolment, patients were randomly assigned to one of two treatment arms in a 1:1 ratio. Patients were blinded into two groups, group 1 (medication group) and group 2 (placebo group). Patients are instructed to take the medication four times daily, during the last 3 days prior to surgery. Results: There were 16 (69.6%) male and 7 (30.4%) in medication group while in placebo group male were15 (65.2%) and female were 8 (34.8%). Mean age in medication group was 46.2 ±15.24 and in placebo group was 48.2 ± 14.55. BMI (Body mass index) in medication group was 29.44 ± 3.74 and in placebo group was 28.76 ± 2.96. Operative time in group medication was 6.4±2.12 and in placebo group was 6.23 ± 1.96. This was not significant. Surgical site infection (SSI) in medication group was 3(13%) and in placebo group was 8(39%). Mean Hospital stay (days) in medication group was 13.11± 2.45 and in placebo group was 16.2±3.87, this was statistically significant. No. of antibiotics required postoperatively in medication group was .2± 1.4 and in placebo group was 6.4±2.4. Conclusion: Administration of oral antibiotics 3 days prior to colorectal surgery can significantly reduce the surgical site infection and mean hospital stay thereby reducing the morbidity.