Trial reportUpdates in surgery2021
Oral neomycin and bacitracin are effective in preventing surgical site infections in elective colorectal surgery: a multicentre, randomized, parallel, single-blinded trial (COLORAL-1).
Trial report in Updates in surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04438655 (Prospective Randomized Clinical Trial on Oral and Intravenous Antibiotic Prophylaxis in Colorectal Surgery), which is not on this map. Cited by 12 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective Randomized Clinical Trial on Oral and Intravenous Antibiotic Prophylaxis in Colorectal Surgery (COLORAL1).
Who cites it
12 citing papers in PubMed, 8 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- A meta-analysis of the effects of preoperative mechanical intestinal preparation and oral antibiotics on surgical site infection after rectal tumor resection.Updates in surgery · 2026Pooled it
- Adding Preoperative Oral Antibiotics to Mechanical Bowel Preparation Reduces Surgical Site Infections in Elective Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Mechanical and oral antibiotics bowel preparation reduce the risk of surgical site infections and anastomotic leakage in colorectal surgery: a GRADE-based meta-analysis and trial sequential analysis.Frontiers in medicine · 2026Pooled it
- The 2024 Korean Enhanced Recovery After Surgery (ERAS) guidelines for colorectal cancer: a secondary publication.Annals of coloproctology · 2025Guideline
- EAES, SAGES, and ESCP rapid guideline: bowel preparation for minimally invasive colorectal resection.Surgical endoscopy · 2023Guideline
- Mechanical bowel preparation and antibiotics in elective colorectal surgery: network meta-analysis.BJS open · 2023Pooled it
- Preoperative combined mechanical and oral antibiotic bowel preparation for preventing complications in elective colorectal surgery.The Cochrane database of systematic reviews · 2023Pooled it
- Mechanical bowel preparation combined with oral antibiotics reduces infectious complications and anastomotic leak in elective colorectal surgery: a pooled-analysis with trial sequential analysis.International journal of colorectal disease · 2023Pooled it
- Review
- Formation and Characterization of Xylitol-Modified Glycidyl Methacrylate-Molecules (Basel, Switzerland) · 2025Article
- The Impact of Mechanical Bowel Preparation and Oral Antibiotics in Colorectal Cancer Surgery (MECCA Study): A Prospective Randomized Clinical Trial.Journal of clinical medicine · 2024Article
- A Network Meta-Analysis and GRADE Assessment of the Effect of Preoperative Oral Antibiotics with and Without Mechanical Bowel Preparation on Surgical Site Infection Rate in Colorectal Surgery.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Several regimens of oral and intravenous antibiotics (OIVA) have been proposed with contradicting results, and the role of mechanical bowel preparation (MBP) is still controversial. This study aims to assess the effectiveness of oral antibiotic prophylaxis in preventing Surgical Site Infections (SSI) in elective colorectal surgery. In a multicentre trial, we randomized patients undergoing elective colorectal resection surgery, comparing the effectiveness of OIVA versus intravenous antibiotics (IVA) regimens to prevent SSI as the primary outcome (NCT04438655). In addition to intravenous Amoxicillin/Clavulanic, patients in the OIVA group received Oral Neomycin and Bacitracin 24 h before surgery. MBP was administered according to local habits which were not changed for the study. The trial was terminated during the COVID-19 pandemic, as many centers failed to participate as well as the pandemic changed the rules for engaging patients. Two-hundred and four patients were enrolled (100 in the OIVA and 104 in the IVA group); 3 SSIs (3.4%) were registered in the OIVA and 14 (14.4%) in the IVA group (p = 0.010). No difference was observed in terms of anastomotic leak. Multivariable analysis indicated that OIVA reduced the rate of SSI (OR 0.21 / 95% CI 0.06-0.78 / p = 0.019), while BMI is a risk factor of SSI (OR 1.15 / 95% CI 1.01-1.30 p = 0.039). Subgroup analysis indicated that 0/22 patients who underwent OIVA/MBP + vs 13/77 IVA/MBP- experienced an SSI (p = 0.037). The early termination of the study prevents any conclusion regarding the interpretation of the data. Nonetheless, Oral Neomycin/Bacitracin and intravenous beta-lactam/beta-lactamases inhibitors seem to reduce SSI after colorectal resections, although not affecting the anastomotic leak in this trial. The role of MBP requires more investigation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.