Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

The Efficacy of Oral Antimicrobials in Reducing Aerobic and Anaerobic Colonic Mucosal Flora

The Efficacy of Oral Antimicrobials in Reducing Aerobic and Anaerobic Colonic Mucosal Flora Abstract • We investigated the impact of intestinal antisepsis on the colonic mucosa-associated flora. Four groups of dogs were studied: group A received no bowel preparation, group B received a three-day clear-liquid diet, group C underwent mechanical cleansing of the bowel, and group D had mechanical cleansing followed by oral neomycin and erythromycin. Mucosal biopsy specimens were obtained for bacteriologic and scanning electron microscopic (SEM) studies. No significant difference in recovery of mucosal bacteria was observed between groups A and B. A significant decrease in recovery of aerobes was observed in group C, and a significant decrease in both aerobes and anaerobes was observed in group D compared with group A; Enterobacteriaceae and Bacteroides were either eliminated or greatly reduced. The SEM analysis of group D revealed a marked decrease in mucosa-associated microflora compared with groups B and C. Oral neomycin-erythromycin produced a significant quantitative reduction in the colonic mucosa-associated bacterial population, including the potentially pathogenic Escherichia coli and Bacteroides fragilis group isolates. These mucosa-associated bacteria are a likely source of contamination of the abdominal cavity and wound at the time of colon surgery. (Arch Surg 1989;124:281-284) References 1. Baum ML, Anish DS, Chalmers TC, et al: A survey of trials of antibiotic prophylaxis in colon surgery: Evidence against further use of notreatment controls . N Engl J Med 1981;305:795-799.Crossref 2. Condon RE, Bartlett JG, Greenlee H, et al: Efficacy of oral and systemic antibiotic prophylaxis in colorectal operations . Arch Surg 1983;118:496-502.Crossref 3. MilesAA, Miles EM, Burke JF: The value and duration of defense reaction of the skin to the primary lodgement of bacteria . Br J Exp Pathol 1957;38:79-96. 4. Clarke JS, Condon RE, Bartlett JG, et al: Preoperative oral antibiotics reduce septic complications of colon operations: Results of a randomized, double-blind clinical study . Ann Surg 1977;186:251-259.Crossref 5. Nichols RL, Condon RE, DiSanto AR: Preoperative bowel preparation . Arch Surg 1977;112:1493-1496.Crossref 6. Nichols RL, Condon RE, Gorbach SL, et al: Efficacy of preoperative antimicrobial preparation of the bowel . Ann Surg 1972;176:227-313.Crossref 7. Edmiston CE, Avant GR, Wilson FA: Anaerobic bacterial populations on normal and diseased human biopsy tissue obtained at colonoscopy . Appl Environ Microbiol 1982;43:1173-1181. 8. Vosbeck K, Handschin H, Menge E, et al: Effects of subminimal inhibitory concentrations of antibiotics on adhesiveness of Escherichia coli in vitro . Rev Infect Dis 1979;1:845-851.Crossref 9. Lennette FH, Spaulding EH, Truant JP (eds): Manual of Clinical Microbiology , ed 3. Washington, DC, American Society for Microbiology, 1985. 10. Holdeman LV, Moore WE: Anaerobic Laboratory Manual , ed 4. Blacksburg, Va, Virginia Polytechnical Institute and State University, 1977. 11. Nichols RL, Broido P, Condon RE, et al: Effect of preoperative neomycin-erythromycin intestinal preparation on the incidence of infectious complications following colon surgery . Ann Surg 1973;178:453-462.Crossref 12. Nichols RL, Condon RE: Antibiotic preparation of the colon: Failure of commonly used regimens . Surg Clin North Am 1971;51:223-231. 13. Kleighley MRB, Drysdale RB, Quoralshi AH, et al: Antibiotic treatment of biliary sepsis . Surg Clin North Am 1975;55:1379-1390. 14. Jones FE, Malangoni MA, Spiegel C, et al: Antibiotic management of intra-abdominal sepsis . Infect Surg 1987;65:15-24. 15. Finegold SM, Flora DJ, Attebery HR, et al: Fecal bacteriology of colonic polyp patients and control patients . Cancer Res 1975;35:3407-3417. 16. Bartlett JG, Condon RE, Gorbach SL, et al: Veterans Administration cooperative study on bowel preparation for elective colorectal operations . Ann Surg 1978;188:249-254.Crossref 17. Edmondson HT, Rissing JP: Prophylactic antibiotics in colon surgery . Arch Surg 1983;118:227-231.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

The Efficacy of Oral Antimicrobials in Reducing Aerobic and Anaerobic Colonic Mucosal Flora

Loading next page...
 
/lp/american-medical-association/the-efficacy-of-oral-antimicrobials-in-reducing-aerobic-and-anaerobic-n06q09Z9WL
Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1989.01410030027003
Publisher site
See Article on Publisher Site

Abstract

Abstract • We investigated the impact of intestinal antisepsis on the colonic mucosa-associated flora. Four groups of dogs were studied: group A received no bowel preparation, group B received a three-day clear-liquid diet, group C underwent mechanical cleansing of the bowel, and group D had mechanical cleansing followed by oral neomycin and erythromycin. Mucosal biopsy specimens were obtained for bacteriologic and scanning electron microscopic (SEM) studies. No significant difference in recovery of mucosal bacteria was observed between groups A and B. A significant decrease in recovery of aerobes was observed in group C, and a significant decrease in both aerobes and anaerobes was observed in group D compared with group A; Enterobacteriaceae and Bacteroides were either eliminated or greatly reduced. The SEM analysis of group D revealed a marked decrease in mucosa-associated microflora compared with groups B and C. Oral neomycin-erythromycin produced a significant quantitative reduction in the colonic mucosa-associated bacterial population, including the potentially pathogenic Escherichia coli and Bacteroides fragilis group isolates. These mucosa-associated bacteria are a likely source of contamination of the abdominal cavity and wound at the time of colon surgery. (Arch Surg 1989;124:281-284) References 1. Baum ML, Anish DS, Chalmers TC, et al: A survey of trials of antibiotic prophylaxis in colon surgery: Evidence against further use of notreatment controls . N Engl J Med 1981;305:795-799.Crossref 2. Condon RE, Bartlett JG, Greenlee H, et al: Efficacy of oral and systemic antibiotic prophylaxis in colorectal operations . Arch Surg 1983;118:496-502.Crossref 3. MilesAA, Miles EM, Burke JF: The value and duration of defense reaction of the skin to the primary lodgement of bacteria . Br J Exp Pathol 1957;38:79-96. 4. Clarke JS, Condon RE, Bartlett JG, et al: Preoperative oral antibiotics reduce septic complications of colon operations: Results of a randomized, double-blind clinical study . Ann Surg 1977;186:251-259.Crossref 5. Nichols RL, Condon RE, DiSanto AR: Preoperative bowel preparation . Arch Surg 1977;112:1493-1496.Crossref 6. Nichols RL, Condon RE, Gorbach SL, et al: Efficacy of preoperative antimicrobial preparation of the bowel . Ann Surg 1972;176:227-313.Crossref 7. Edmiston CE, Avant GR, Wilson FA: Anaerobic bacterial populations on normal and diseased human biopsy tissue obtained at colonoscopy . Appl Environ Microbiol 1982;43:1173-1181. 8. Vosbeck K, Handschin H, Menge E, et al: Effects of subminimal inhibitory concentrations of antibiotics on adhesiveness of Escherichia coli in vitro . Rev Infect Dis 1979;1:845-851.Crossref 9. Lennette FH, Spaulding EH, Truant JP (eds): Manual of Clinical Microbiology , ed 3. Washington, DC, American Society for Microbiology, 1985. 10. Holdeman LV, Moore WE: Anaerobic Laboratory Manual , ed 4. Blacksburg, Va, Virginia Polytechnical Institute and State University, 1977. 11. Nichols RL, Broido P, Condon RE, et al: Effect of preoperative neomycin-erythromycin intestinal preparation on the incidence of infectious complications following colon surgery . Ann Surg 1973;178:453-462.Crossref 12. Nichols RL, Condon RE: Antibiotic preparation of the colon: Failure of commonly used regimens . Surg Clin North Am 1971;51:223-231. 13. Kleighley MRB, Drysdale RB, Quoralshi AH, et al: Antibiotic treatment of biliary sepsis . Surg Clin North Am 1975;55:1379-1390. 14. Jones FE, Malangoni MA, Spiegel C, et al: Antibiotic management of intra-abdominal sepsis . Infect Surg 1987;65:15-24. 15. Finegold SM, Flora DJ, Attebery HR, et al: Fecal bacteriology of colonic polyp patients and control patients . Cancer Res 1975;35:3407-3417. 16. Bartlett JG, Condon RE, Gorbach SL, et al: Veterans Administration cooperative study on bowel preparation for elective colorectal operations . Ann Surg 1978;188:249-254.Crossref 17. Edmondson HT, Rissing JP: Prophylactic antibiotics in colon surgery . Arch Surg 1983;118:227-231.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Mar 1, 1989

References