정규 결장수술 후 예방적 항생제로 2제 병용요법과 3제 병용요법의 비교
Dual Therapy and Triple Therapy of Prophylactic Antibiotics After Elective Colorectal Surgery: A Comparative Study
김윤석, 이승현, 안병권, 백승언,
소속 상세정보
김윤석 ( Kim Yoon-Seok )
고신대학교 의과대학 외과학교실
이승현 ( Lee Seung-Hyun )
고신대학교 의과대학 외과학교실
안병권 ( Ahn Byung-Kwon )
고신대학교 의과대학 외과학교실
백승언 ( Baek Sung-Uhn )
고신대학교 의과대학 외과학교실
KMID : 0356720090250010014
Abstract
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 no advantage in prevention of postoperative wound complications. Further studies are required to establish appropriate guideline of antibiotic prophylaxis after elective colorectal surgery.
키워드
예방적 항생제;결장직장수술;2제 병용요법;3제 병용요법
Prophylactic antibiotics;Colorectal surgery;Dual therapy;Triple therapy
원문 및 링크아웃 정보
등재저널 정보