Annals of Coloproctology

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Inflammatory/benign bowel disease

Clinical outcomes and optimal indications for nonoperative management of acute appendicitis in adult patients: a comprehensive literature review: Hyun Gu Lee, In Ja Park; Ann Coloproctol. 2025;41(2):107-118. Published online April 16, 2025; DOI: https://doi.org/10.3393/ac.2023.00192.0027

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Appendectomy as the standard treatment for acute appendicitis has been challenged by accumulating evidence supporting nonoperative management with antibiotics as a potential primary treatment. This review aimed to summarize the clinical outcomes and the optimal indications for nonoperative management of acute appendicitis in adults. Current evidence suggests that uncomplicated and complicated appendicitis have different pathophysiologies and should be treated differently. Nonoperative management for uncomplicated appendicitis was not inferior to appendectomy in terms of complications and length of stay, with less than a 30% failure rate at 1 year. The risk of perforation and postoperative complications did not increase even if nonoperative management failed. Complicated appendicitis with localized abscess or phlegmon could also be treated conservatively, with a success rate of more than 80%. An interval appendectomy following successful nonoperative management is recommended only for patients over the age of 40 years to exclude appendiceal malignancy. The presence of appendicoliths increased the risk of treatment failure and complications; thus, it may be an indication for appendectomy. Nonoperative management is a safe and feasible option for both uncomplicated and complicated appendicitis. Patients should be informed that nonoperative management may be a safe alternative to surgery, with the possibility of treatment failure.

Citations

Citations to this article as recorded by

Three-year follow-up of antibiotics versus surgery for acute appendicitis
S Bose, HJ Wong, C Skouras, Y Maeda
The Annals of The Royal College of Surgeons of England.2026;[Epub] CrossRef
Appendicolith in non-operative management of acute appendicitis: Implications for recurrence and future directions
Ju Tian
World Journal of Clinical Cases.2025;[Epub] CrossRef

Benign GI diease,Epidemiology & etiology

A Review of Bowel Preparation Before Colorectal Surgery: Yeon Uk Ju, Byung Wook Min; Ann Coloproctol. 2021;37(2):75-84. Published online May 15, 2020; DOI: https://doi.org/10.3393/ac.2020.04.01

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16 Web of Science
14 Citations

Abstract PDF

Infectious complications are the biggest problem during bowel surgery, and one of the approaches to minimize them is the bowel cleaning method. It was expected that bowel cleaning could facilitate bowel manipulation as well as prevent infectious complications and further reduce anastomotic leakage. In the past, with the development of antibiotics, bowel cleaning and oral antibiotics (OA) were used together. However, with the success of emergency surgery and Enhanced Recovery After Surgery, bowel cleaning was not routinely performed. Consequently, bowel cleaning using OA was gradually no longer used. Recently, there have been reports that only bowel cleaning is not helpful in reducing infectious complications such as surgical site infection (SSI) compared to OA and bowel cleaning. Accordingly, in order to reduce SSI, guidelines are changing the trend of only intestinal cleaning. However, a consistent regimen has not yet been established, and there is still controversy depending on the location of the lesion and the surgical method. Moreover, complications such as Clostridium difficile infection have not been clearly analyzed. In the present review, we considered the overall bowel preparation trends and identified the areas that require further research.

Citations

Citations to this article as recorded by

General Principles of Risk Mitigation before Colorectal Surgery
Sarah Atoui, A. Sender Liberman
Clinics in Colon and Rectal Surgery.2026; 39(01): 015. CrossRef
Curiosity and the Cat
Lester Gottesman
Diseases of the Colon & Rectum.2026; 69(1): 1. CrossRef
Die Rolle des intestinalen Mikrobioms in der Pathogenese postoperativer Infektionen
Kamacay Cira
coloproctology.2026;[Epub] CrossRef
Advanced Protocols for Preoperative Colon Preparation: Enhancing Outcomes in Colorectal Surgery
Marian Cerny, Ľudovít Danihel, Milan Schnorrer, Stefan Durdik
Polish Journal of Surgery.2025; 97(5): 37. CrossRef
Feasibility of the ERAS (Enhanced Recovery After Surgery) Protocol in Patients Undergoing Gastrointestinal Cancer Surgeries in a Tertiary Care Hospital—A Prospective Interventional Study
Surya Theja, Seema Mishra, Sandeep Bhoriwal, Rakesh Garg, Sachidanand Jee Bharati, Vinod Kumar, Nishkarsh Gupta, Saurabh Vig, Sunil Kumar, S. V. S. Deo, Sushma Bhatnagar
Indian Journal of Surgical Oncology.2024; 15(2): 304. CrossRef
Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery
Hayoung Lee, Jong Lyul Lee, Ji Sung Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim
World Journal of Surgery.2024; 48(6): 1534. CrossRef
The Impact of Surgical Bowel Preparation on the Microbiome in Colon and Rectal Surgery
Lauren Weaver, Alexander Troester, Cyrus Jahansouz
Antibiotics.2024; 13(7): 580. CrossRef
Pre-Operative Mechanical Bowel Preparation Does Not Affect the Impact of Anastomosis Leakage in Left-Side Colorectal Surgery—A Single Center Observational Study
Ludovít Danihel, Marian Cerny, Ivor Dropco, Petra Zrnikova, Milan Schnorrer, Marek Smolar, Miloslav Misanik, Stefan Durdik
Life.2024; 14(9): 1092. CrossRef
Bowel cleansing, dysbiosis, and postoperative infection: the dots are starting to connect
John C Alverdy
British Journal of Surgery.2024;[Epub] CrossRef
A prospective, randomized assessment of a novel, local antibiotic releasing platform for the prevention of superficial and deep surgical site infections
O. Zmora, Y. Stark, O. Belotserkovsky, M. Reichert, G. A. Kozloski, N. Wasserberg, H. Tulchinsky, L. Segev, A. J. Senagore, N. Emanuel
Techniques in Coloproctology.2023; 27(3): 209. CrossRef
Bacterial Decontamination: Bowel Preparation and Chlorhexidine Bathing
Yadin Bornstein, Elizabeth C. Wick
Clinics in Colon and Rectal Surgery.2023; 36(03): 201. CrossRef
Effect of non-mechanical bowel preparation on postoperative gastrointestinal recovery following surgery on malignant gynecological tumors: A randomized controlled trial
Shan-shan Wang, Hong-yan Xu, Xing-xia Li, Su-wen Feng
European Journal of Oncology Nursing.2023; 64: 102320. CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
The Impact of the Enhanced Recovery After Surgery (ERAS) Protocol on Colorectal Surgery in a Portuguese Tertiary Hospital
Catarina Lopes, Mariana Vaz Gomes, Manuel Rosete, Ana Almeida, Luisa Isabel Silva, José Guilherme Tralhão
Acta Médica Portuguesa.2022; 36(4): 254. CrossRef

Original Articles

Short-term Intravenous Antibiotic Treatment in Uncomplicated Diverticulitis Does Not Increase the Risk of Recurrence Compared to Long-term Treatment: Cosimo Riccardo Scarpa, Nicolas Christian Buchs, Antoine Poncet, Béatrice Konrad-Mugnier, Pascal Gervaz, Philippe Morel, Frédéric Ris; Ann Coloproctol. 2015;31(2):52-56. Published online April 30, 2015; DOI: https://doi.org/10.3393/ac.2015.31.2.52

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14 Web of Science
12 Citations

Abstract PDF

Purpose

This study included all patients treated at the University Hospital of Geneva for a first episode of uncomplicated diverticulitis. Risks of recurrence and treatment failure were evaluated by comparing the results between short-course and long-course intravenous (IV) antibiotic therapy groups.

Methods

The records of all patients hospitalized at our facility from January 2007 to February 2012 for a first episode of uncomplicated diverticulitis (Hinchey Ia), as confirmed by computed tomography, were prospectively collected. We published an auxiliary analysis from this registered study at Clinicaltrials.gov (identifier number: NCT01015378). Two groups of patients were considered: one received a short-course IV antibiotic arm (ceftriaxone and metronidazole) for up to 5 days (followed by 5 days of oral antibiotics); the other received a long-course IV arm between days 5 and 10. The primary outcome was the recurrence-free survival time.

Results

Follow-up was completed for 256 patients-50% men and 50% women, with a median age of 56 years (range, 24-85 years). The average follow-up was 50 months (range, 19-89 months). Of the 256 patients included in the study, 46 patients received a short-course IV antibiotic treatment and 210 received a long-course treatment. The recurrence-free survivals were very similar between the two groups, which was supported by a log rank test (P = 0.772). Four treatment failures, all in the long-course IV antibiotic treatment group, occurred.

Conclusion

Treatment of diverticulitis with a short IV antibiotic treatment is possible and does not modify the recurrence rate in patients with uncomplicated diverticulitis.

Citations

Citations to this article as recorded by

Italian guidelines for the diagnosis and management of colonic diverticulosis and diverticular disease
Marilia Carabotti, Costantino Sgamato, Antonio Amato, Benedetta Beltrame, Gian Andrea Binda, Bastianello Germanà, Gioacchino Leandro, Luigi Pasquale, Sergio Peralta, Maria Teresa Viggiani, Carola Severi, Bruno Annibale, Rosario Cuomo
Digestive and Liver Disease.2024; 56(12): 1989. CrossRef
Konservative Therapie der Divertikulitis
Stephan K. Böhm
coloproctology.2023; 45(3): 163. CrossRef
Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis
Ethan M. Balk, Gaelen P. Adam, Monika Reddy Bhuma, Kristin J. Konnyu, Ian J. Saldanha, Michael D. Beland, Nishit Shah
Annals of Internal Medicine.2022; 175(3): 379. CrossRef
Diagnosis and Management of Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians
Amir Qaseem, Itziar Etxeandia-Ikobaltzeta, Jennifer S. Lin, Nick Fitterman, Tatyana Shamliyan, Timothy J. Wilt
Annals of Internal Medicine.2022; 175(3): 399. CrossRef
S3-Leitlinie Divertikelkrankheit/Divertikulitis – Gemeinsame Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV)
Ludger Leifeld, Christoph-Thomas Germer, Stephan Böhm, Franz Ludwig Dumoulin, Thomas Frieling, Martin Kreis, Alexander Meining, Joachim Labenz, Johan Friso Lock, Jörg-Peter Ritz, Andreas Schreyer, Wolfgang Kruis
Zeitschrift für Gastroenterologie.2022; 60(04): 613. CrossRef
Recurrence of Uncomplicated Diverticulitis: A Meta-Analysis
Guhyun Kang, Soomin Son, Young-Min Shin, Jung-Soo Pyo
Medicina.2022; 58(6): 758. CrossRef
German guideline diverticular disease/diverticulitis
Wolfgang Kruis, Christoph‐Thomas Germer, Stephan Böhm, Franz Ludwig Dumoulin, Thomas Frieling, Jochen Hampe, Jutta Keller, Martin E. Kreis, Alexander Meining, Joachim Labenz, Johann F. Lock, Jörg Peter Ritz, Andreas G. Schreyer, Ludger Leifeld
United European Gastroenterology Journal.2022; 10(9): 940. CrossRef
Treatment with Ceftriaxone in Complicated Diverticulitis Increases the Incidence of Intra-Abdominal Enterococcus faecium Detection
Julius Pochhammer, Axel Kramer, Matthias Orth, Michael Schäffer, Jan Henrik Beckmann
Surgical Infections.2021; 22(5): 543. CrossRef
Risk factors for recurrence after acute colonic diverticulitis: a systematic review
Line Hupfeld, Jakob Burcharth, Hans-Christian Pommergaard, Jacob Rosenberg
International Journal of Colorectal Disease.2017; 32(5): 611. CrossRef
Acute colonic diverticulitis: an update on clinical classification and management with MDCT correlation
Maxime Barat, Anthony Dohan, Karine Pautrat, Mourad Boudiaf, Raphael Dautry, Youcef Guerrache, Marc Pocard, Christine Hoeffel, Clarisse Eveno, Philippe Soyer
Abdominal Radiology.2016; 41(9): 1842. CrossRef
The Wind of Change: Uncomplicated Diverticulitis
Hungdai Kim
Annals of Coloproctology.2015; 31(2): 43. CrossRef
Intermittent bacteremia detected in an asymptomatic apheresis platelet donor with repeat positive culture for Escherichia coli: a case report
Sandra Ramirez‐Arcos, Ted Alport, Mindy Goldman
Transfusion.2015; 55(11): 2606. CrossRef

Mechanical Bowel Preparation and Prophylactic Antibiotic Administration in Colorectal Surgery: A Survey of the Current Status in Korea: Byung Mo Kang, Kil Yeon Lee, Sun Jin Park, Suk-Hwan Lee; Ann Coloproctol. 2013;29(4):160-166. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.160

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19 Citations

Abstract PDF

Purpose

The usefulness of mechanical bowel preparation (MBP) in colon surgery was recently challenged by many multicenter clinical trials and meta-analyses. The objectives of this study were to investigate current national opinions about MBP and prophylactic antibiotics (PA) and to provide preliminary data for developing future Korean guidelines for MBP and PA administration in colorectal surgery.

Methods

A questionnaire was mailed to 129 colorectal specialists. The questionnaires addressed the characteristics of the hospital, the MBP methods, and the uses of oral and intravenous antibiotics.

Results

A total of 73 questionnaires (56.6%) were returned. First, in regard to MBP methods, most surgeons (97.3%) used MBP for a mean of 1.36 days. Most surgeons (98.6%) implemented whole bowel irrigation and used polyethylene glycol (83.3%). Oral antibiotic use was indicated in over half (52.1%) of the responses, the average number of preoperative doses was three, and the mean time of administration was 24.2 hours prior to the operation. Finally, the majority of responders stated that they used intravenous antibiotics (95.9%). The responses demonstrated that second-generation cephalosporin-based regimens were most commonly prescribed, and 75% of the surgeons administered these regimens until three days after the operation.

Conclusion

The results indicate that most surgeons used MBP and intravenous antibiotics and that half of them administered oral PA in colorectal surgery preparations. The study recommends that the current Korean guidelines should be adapted to adequately reflect the medical status in Korea, to consider the medical environment of the various hospitals, and to establish more accurate and relevant guidelines.

Citations

Citations to this article as recorded by

RETRACTED: A meta‐analysis of the risk factors for surgical site infection in patients with colorectal cancer
Yani Chen, Hua Guo, Tian Gao, Jiale Yu, Yujia Wang, Haiquan Yu
International Wound Journal.2024;[Epub] CrossRef
Surgical Site Infections in Colorectal Cancer Surgeries: A Systematic Review and Meta-Analysis of the Impact of Surgical Approach and Associated Risk Factors
Valentin Calu, Catalin Piriianu, Adrian Miron, Valentin Titus Grigorean
Life.2024; 14(7): 850. CrossRef
Uncovering the Function of MBP and Antibiotics in Preventing Surgical Site Infections during Colorectal Procedures
Agnes Sara Shibu, Rojin G. Raj, Rohit Singh Deo
Journal of Coloproctology.2024; 44(03): e209. CrossRef
Single-Dose Versus Multiple-Dose Prophylactic Antibiotics in Minimally Invasive Colorectal Surgery: A Propensity Score Matched Analysis
Ga Yoon Ku, Beom-jin Kim, Ji Won Park, Min Jung Kim, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park
Journal of Korean Medical Science.2024;[Epub] CrossRef
Preoperative mechanical bowel preparation using conventional versus hyperosmolar polyethylene glycol-electrolyte lavage solution before laparoscopic resection for colorectal cancer (TLUMP test): a phase III, multicenter randomized controlled non-inferiori
Tadashi Yoshida, Shigenori Homma, Nobuki Ichikawa, Yosuke Ohno, Yoichi Miyaoka, Hiroki Matsui, Ken Imaizumi, Hiroyuki Ishizu, Tohru Funakoshi, Masahiko Koike, Hirofumi Kon, Yo Kamiizumi, Yasuhiro Tani, Yoichi Minagawa Ito, Kazufumi Okada, Akinobu Taketomi
Journal of Gastroenterology.2023; 58(9): 883. CrossRef
The risk of surgical site infection of oral sulfate tablet versus sodium picosulfate for bowel preparation in colorectal cancer surgery: a randomized clinical trial
Sung Sil Park, Sung Chan Park, Dong-Eun Lee, Dong Woon Lee, Kiho Yu, Hyoung-Chul Park, Chang Won Hong, Dae Kyung Sohn, Kyung Su Han, Bun Kim, Byung Chang Kim, Jae Hwan Oh
Annals of Surgical Treatment and Research.2022; 103(2): 96. CrossRef
Preoperative Elemental Diet before Laparoscopic Anterior Resection in Patients with Advanced Stenotic Rectal Cancer
Tadashi Yoshida, Shigenori Homma, Nobuki Ichikawa, Hiroaki Iijima, Akinobu Taketomi
Journal of the Anus, Rectum and Colon.2021; 5(4): 395. CrossRef
Orale Antibiotikaprophylaxe zur Darmdekontamination vor elektiver kolorektaler Chirurgie
S. Flemming, C.-T. Germer
Der Chirurg.2020; 91(2): 128. CrossRef
Role of Mechanical Bowel Preparation for Elective Colorectal Surgery
Ik Yong Kim
The Korean Journal of Gastroenterology.2020; 75(2): 79. CrossRef
Update on risk factors of surgical site infection in colorectal cancer: a systematic review and meta-analysis
Zhaohui Xu, Hui Qu, George Kanani, Zhong Guo, Yanying Ren, Xin Chen
International Journal of Colorectal Disease.2020; 35(12): 2147. CrossRef
Does Mechanical Bowel Preparation Ameliorate Surgical Performance in Anterior Lumbar Interbody Fusion?
Chang-Hoon Jeon, Han-Dong Lee, Nam-Su Chung
Global Spine Journal.2019; 9(7): 692. CrossRef
Mechanical Bowel Preparation Does Not Affect Clinical Severity of Anastomotic Leakage in Rectal Cancer Surgery
Woong Bae Ji, Koo Yong Hahn, Jung Myun Kwak, Dong Woo Kang, Se Jin Baek, Jin Kim, Seon Hahn Kim
World Journal of Surgery.2017; 41(5): 1366. CrossRef
Comparing Mechanical Bowel Preparation With Both Oral and Systemic Antibiotics Versus Mechanical Bowel Preparation and Systemic Antibiotics Alone for the Prevention of Surgical Site Infection After Elective Colorectal Surgery
Min Chen, Xue Song, Liang-zhou Chen, Zhi-dong Lin, Xue-li Zhang
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Early Outcomes of Endoscopic Submucosal Dissection for Colorectal Neoplasms According to Clinical Indications
Eui-Gon Youk, Dae Kyng Sohn, Chang Won Hong, Seong Dae Lee, Kyung Su Han, Byung Chang Kim, Hee Jin Chang, Mi-Jung Kim
Diseases of the Colon & Rectum.2016; 59(5): 403. CrossRef
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A. C. A. Murray, R. P. Kiran
Langenbeck's Archives of Surgery.2016; 401(5): 573. CrossRef
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Zhobin Moghadamyeghaneh, Mark H. Hanna, Joseph C. Carmichael, Steven D. Mills, Alessio Pigazzi, Ninh T. Nguyen, Michael J. Stamos
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Influence of Shorter Duration of Prophylactic Antibiotic Use on the Incidence of Surgical Site Infection Following Colorectal Cancer Surgery
Youn Young Park, Chang Woo Kim, Sun Jin Park, Kil Yeon Lee, Jung Joo Lee, Hye Ok Lee, Suk-Hwan Lee
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Mechanical Bowel Preparation: Keep It or Abandon It?
Hungdai Kim
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Randomized Controlled Trial

A Prospective, Multicenter, Randomized Trial for Duration of the Prophylactic Antibiotics after Elective Colorectal Surgery: 3 Days versus 5 Days.: Park, Ji Won , Oh, Jae Hwan , Choi, Hyo Seong , Yoo, Sang Bum , Choe, Young Ju , Park, Sohee , Kim, Jung Man , Lee, Kang Young , Sohn, Seung Kook , Yun, Hae Ran , Chun, Ho Kyung , Lee, Woo Yong; J Korean Soc Coloproctol. 2010;26(2):123-128.; DOI: https://doi.org/10.3393/jksc.2010.26.2.123

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5 Citations

Abstract PDF

PURPOSE
The use of prophylactic antibiotics in elective colorectal surgery is essential. Although postoperative prophylactic antibiotics are recommended within 24 hr, the optimal duration of the use of prophylactic antibiotics after colorectal surgery has not yet been fully proven in Korea. The aim of this study was to compare infectious outcomes in elective colorectal cancer surgery between postoperative 3-day antibiotic therapy and 5-day therapy.
METHODS
We conducted a multicenter, randomized trial of a 3-day use vs. a 5-day use of the second-generation cephalosporin cefotetan after elective colorectal surgery. The main outcome measures were the incidences of surgical site infection and all other infectious complications within 21 days after surgery.
RESULTS
A total of 306 patients were enrolled. Fifty-one patients were excluded because they received additional surgery or dropped out during the study. Two-hundred fifty-five patients were analyzed in this study. The two groups were similar in terms of demographics, ASA score, tumor location, tumor stage, surgical approach (conventional open vs. laparoscopy-assisted vs. robotic-assisted), and type of operation. The incidences of surgical site infection were not significantly different between the 3-day use group (4/130 or 3.1%) and the 5-day use group (3/125 or 2.4%) (P=1.000). Incidences of overall infectious diseases did not differ significantly between the two groups. Postoperatively, both groups had similar values in their white blood cell count, absolute neutrophil count, and C-reactive protein levels. However, the number of patients is small to draw a definite conclusion in this study.
CONCLUSION
Three-day cefotetan administration may be not inferior in preventing surgical site infection compared to 5-day antibiotic administration. However, further studies with a large number of patients are needed before a definite conclusion can be drawn.

Citations

Citations to this article as recorded by

Comparing the Postoperative Complications, Hospitalization Days and Treatment Expenses Depending on the Administration of Postoperative Prophylactic Antibiotics to Hysterectomy
Mi Young Jung, Kyung-Yeon Park
Korean Journal of Women Health Nursing.2017; 23(1): 42. CrossRef
Influence of Shorter Duration of Prophylactic Antibiotic Use on the Incidence of Surgical Site Infection Following Colorectal Cancer Surgery
Youn Young Park, Chang Woo Kim, Sun Jin Park, Kil Yeon Lee, Jung Joo Lee, Hye Ok Lee, Suk-Hwan Lee
Annals of Coloproctology.2015; 31(6): 235. CrossRef
Antimicrobial prophylaxis for colorectal surgery
Richard L Nelson, Ed Gladman, Marija Barbateskovic
Cochrane Database of Systematic Reviews.2014;[Epub] CrossRef
Impact of a national hospital evaluation program using clinical performance indicators on the use of surgical antibiotic prophylaxis in Korea
Eu Suk Kim, Sang-Won Park, Chang-Seop Lee, Yee Gyung Kwak, Chisook Moon, Baek-Nam Kim
International Journal of Infectious Diseases.2012; 16(3): e187. CrossRef
Overview of Antibiotic Use in Korea
Baek-Nam Kim
Infection & Chemotherapy.2012; 44(4): 250. CrossRef

Original Article

Dual Therapy and Triple Therapy of Prophylactic Antibiotics After Elective Colorectal Surgery: A Comparative Study.: Kim, Yoon Seok , Lee, Seung Hyun , Ahn, Byung Kwon , Baek, Sung Uhn; J Korean Soc Coloproctol. 2009;25(1):14-19.; DOI: https://doi.org/10.3393/jksc.2009.25.1.14

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22 Download
4 Citations

Abstract PDF

PURPOSE
The use of prophylactic antibiotics is the current standard of care after elective colorectal surgery. The aim of this study was to compare the efficacy of antibiotic prophylaxis with dual antibiotic therapy and triple antibiotic therapy after elective colorectal surgery.
METHODS
We studied consecutive patients underwent elective colorectal surgery from January to June, 2007. Patients of triple-therapy group were administered second cephalosporin, metronidazole, and aminoglycoside for early 3 mo and dual-therapy group were administered second cephalosporin and metronidazole for next 3 mo. The prophylactic antibiotics were administered 2-3 doses for 24 hr after surgery. The surgery for diverticulitis, inflammatory bowel disease, and colon obstruction were excluded. Wound conditions were checked on alternate days during the hospital stay and follow up at least for 30 days after discharge.
RESULTS
Over 6 mo, 110 patients were enrolled (59 dual-therapy group, 51 triple-therapy group). In two group, sex, age, American Society of Anesthesiology score, body mass index, combined diseases, and location of disease were similar. Wound infection rate were 1.7% in dual-therapy group and 2.0% in triple-therapy group (P=1.0). Anastomotic leakage rate were 5.1% in dual-therapy group and 2.0% in triple-therapy group (P=0.622).
CONCLUSION
The addition of aminoglycoside to dual antibiotic therapy, second cephalosporin-metronidazole showed on advantage in prevention of postoperative wound complications. Further studies are required to establish appropriate guideline of antibiotic prophylaxis after elective colorectal surgery.

Citations

Citations to this article as recorded by

Overview of Antibiotic Use in Korea
Baek-Nam Kim
Infection & Chemotherapy.2012; 44(4): 250. CrossRef
A Prospective, Multicenter, Randomized Trial for Duration of the Prophylactic Antibiotics after Elective Colorectal Surgery: 3 Days versus 5 Days
Ji Won Park, Jae Hwan Oh, Hyo Seong Choi, Sang-Bum Yoo, Young-Ju Choe, Sohee Park, Jung Man Kim, Kang Young Lee, Seung Kook Sohn, Hae Ran Yun, Ho-Kyung Chun, Woo Yong Lee
Journal of the Korean Society of Coloproctology.2010; 26(2): 123. CrossRef
Antimicrobial Prophylaxis Using a 2nd Generation Cephalosporin after Laparoscopic Colorectal Resection: A Randomized Trial of 1-day vs. 3-day
Han Deok Kwak, Dong Jin Choi, Si Uk Woo, Jin Kim, Jun Won Um, Seon Hahn Kim
Journal of the Korean Surgical Society.2010; 78(6): 385. CrossRef
Association Between Prophylactic Antibiotic Use and Surgical Site Infection Based on Quality Assessment Data in Korea
Kyoung Hoon Kim, Choon Seon Park, Jin Hee Chang, Nam Soon Kim, Jin Seo Lee, Bo Ram Choi, Byung Ran Lee, Kyoo Duck Lee, Sun Min Kim, Seon A Yeom
Journal of Preventive Medicine and Public Health.2010; 43(3): 235. CrossRef

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