Evidence map›Paper›PMID 37555867›Full record

Observational studyInternational journal of colorectal disease2023

Oral antibiotics and mechanical bowel preparation for colorectal surgery: A prospective observational study of surgical site infection and microbial analysis.

Martin Rutegård, Alethea Tang, Darren James Gregoire, Christopher Stewart, Libor Hurt, Susan Chandler, Matthew David Hitchings, Brendan Healy, Dean Harris

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in International journal of colorectal disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Martin RutegårdDepartment of Colorectal Surgery, Morriston Hospital, Swansea Bay University Health Board, Swansea, UK. martin.rutegard@umu.se.ORCID http://orcid.org/0000-0002-0974-6373
Alethea TangDepartment of Colorectal Surgery, Morriston Hospital, Swansea Bay University Health Board, Swansea, UK.
Darren James GregoireDepartment of Colorectal Surgery, Morriston Hospital, Swansea Bay University Health Board, Swansea, UK.
Christopher StewartDepartment of Colorectal Surgery, Morriston Hospital, Swansea Bay University Health Board, Swansea, UK.
Libor HurtDepartment of Colorectal Surgery, Morriston Hospital, Swansea Bay University Health Board, Swansea, UK.
Susan ChandlerDepartment of Colorectal Surgery, Morriston Hospital, Swansea Bay University Health Board, Swansea, UK.
Matthew David HitchingsFaculty of Medicine, Health and Life Sciences, Swansea University, Swansea, UK.
Brendan HealyPublic Health Wales, Swansea Bay University Health Board, Swansea, UK.
Dean HarrisDepartment of Colorectal Surgery, Morriston Hospital, Swansea Bay University Health Board, Swansea, UK.
Swansea Bay University Health Board · GBSwansea University · GB

Funding

Bengt Ihre's Foundation, Sweden SLS-934603Cancer Research Foundation in Northern Sweden AMP 19-978Svenska Läkaresällskapet SLS-934594
6 · The paper itself

Abstract

purposeSurgical site infections (SSIs) are common in colorectal surgery. Mechanical bowel preparation (MBP) in conjunction with oral antibiotics (OABs) have been shown to reduce SSI rates. It however is still unclear which OABs to use, and how this can be implemented in practice.

methodsThis is a prospective observational study carried out in Swansea Bay University Health Board during 2019-2021, evaluating the introduction of OABs in a stepwise manner on the incidence of SSI in major colorectal surgery. A control group having MBP only was compared to two OAB groups: one group had MBP plus metronidazole only and the second MBP plus metronidazole and neomycin. A 30-day follow-up after surgery was ascertained via chart review and telephone contact. Logistic regression was performed to estimate the relation between OAB use and SSI, with adjustment for confounding. In a subset of patients, faecal samples were analysed through 16S rRNA amplicon sequencing before and after OAB treatment, depicting the impact of the gut microbiome.

resultsIn total 160 patients were analysed: 46 patients had MBP only, whilst 76 patients had MBP plus metronidazole only and 38 patients had MBP with metronidazole/neomycin. The SSI rate in the entire cohort was 33.8%, whilst the adjusted ORs for the single- and dual-OAB groups were 0.76 (95% CI: 0.17-1.81) and 0.50 (95% CI: 0.17-1.52). The microbial analysis demonstrated that the relative abundance for many bacterial genera was changed before and after OAB treatment, but no link with SSI development could be shown.

conclusionsIntroduction of OABs in conjunction with MBP in colorectal surgery is feasible, and may potentially lead to lower rates of SSI, as well as altering the community structure of the faecal microbiome. More research is needed, especially considering different OABs and mechanistic studies of the gut microbiome in the context of colorectal surgery.

Indexed as

Anti-Bacterial AgentsColorectal SurgeryAdministration, OralAntibiotic ProphylaxisCatharticsElective Surgical ProceduresHumansMetronidazoleNeomycinPreoperative CareRNA, Ribosomal, 16SSurgical Wound InfectionAnti-Bacterial AgentsCatharticsMetronidazoleNeomycinRNA, Ribosomal, 16SAbscessAnastomotic leakAntibioticsColorectal cancerInfectionLaxatives

Identifiers

PMID37555867
PMCPMC10412473
OpenAlexW4385684718

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.