A recent clinical trial investigated the efficacy of oral antimicrobial prophylaxis as an adjunct to intravenous antibiotic prophylaxis in reducing SSIs after elective colorectal surgery.
Surgical site infections (SSIs) are a major complication of colorectal surgery that can lead to prolonged hospital stays, readmission, and even death. As such, prevention of SSIs is of utmost importance to ensure positive surgical outcomes.
The trial, conducted in 11 university and non-university hospitals in France between May 2016 and August 2019, enrolled 926 adults scheduled for elective colorectal surgery. Patients were randomly assigned to receive either a single 1 g dose of ornidazole (Number of patients=463) or placebo (Number of patients=463) orally 12 hours before surgery, in addition to intravenous antimicrobial prophylaxis before surgical incision.
The primary outcome of the trial was the proportion of patients with surgical site infection within 30 days after surgery. The trial also measured secondary outcomes, including individual types of surgical site infections and major postoperative complications within 30 days after surgery.
The results of the trial showed that the addition of a single 1 g dose of ornidazole significantly reduced surgical site infections among adults undergoing elective colorectal surgery. Specifically, surgical site infection within 30 days after surgery occurred in 13% of patients in the oral prophylaxis group compared to 22% in the placebo group. The proportion of patients with deep infections and organ space infections was also lower in the oral prophylaxis group. In addition, major postoperative complications occurred in a smaller proportion of patients in the oral prophylaxis group compared to the placebo group.
These findings have significant implications for the prevention of SSIs after colorectal surgery. The addition of oral antimicrobial prophylaxis to intravenous antibiotic prophylaxis could significantly reduce the incidence of SSIs and improve surgical outcomes.
As a patient undergoing colorectal surgery, it is important to discuss the use of oral antimicrobial prophylaxis with your healthcare provider. While the results of this trial are promising, the decision to use oral antimicrobial prophylaxis should be based on individual patient factors and the risk of SSIs. In addition, patients should continue to adhere to other preventive measures, such as proper wound care and hand hygiene, to further reduce the risk of SSIs.
The addition of a single 1 g dose of ornidazole to intravenous antibiotic prophylaxis significantly reduces the incidence of SSIs after elective colorectal surgery. This finding has important implications for the prevention of SSIs and improving surgical outcomes. However, further research is needed to determine the optimal use of oral antimicrobial prophylaxis in this patient population.__________