Cai C J
Zhong-shan Hospital, Shanghai Medical University.
Zhonghua Wai Ke Za Zhi. 1992 Apr;30(4):237-40, 256.
From Oct. 1989 to Apr. 1990, 16 patients with colorectal carcinoma undergoing elective radical resection were randomly divided into two groups to receive oral and combined (oral + i.v.) antimicrobials respectively. Patients in the oral group received preoperative oral gentamicin and metronidazole for two days, in the combined group oral medication was followed by the same antimicrobials intravenously during perioperative period. Quantitative bacterial cultures were performed before and after the regimen. Results showed that the preoperative prophylaxis with oral antimicrobial resulted in a significant reduction in the bacterial counts of the rectum contents in all the patients (P < 0.001). The NICs of gentamicin and metronidazole for E. coli and B. fragilis were found to be 2.31 micrograms/ml and 0.66 micrograms/ml respectively. The perioperative blood samples and the intraoperative tissue specimens were taken for gentamicin and metronidazole determination. In the oral group, effective concentration of metronidazole were found in serum and tissues but gentamicin was undetected. In the combined group, effective concentrations of both gentamicin and metronidazole were detected. According to our results, the short-term preoperative oral medications combined with perioperative intravenous gentamicin and metronidazole prophylaxis appears to rational.
1989年10月至1990年4月，16例接受择期根治性切除术的结直肠癌患者被随机分为两组，分别接受口服和联合（口服+静脉注射）抗菌药物治疗。口服组患者术前口服庆大霉素和甲硝唑两天，联合组在围手术期口服药物后静脉注射相同的抗菌药物。在治疗方案前后进行定量细菌培养。结果显示，术前口服抗菌药物预防导致所有患者直肠内容物细菌计数显著降低（P<0.001）。发现庆大霉素和甲硝唑对大肠杆菌和脆弱拟杆菌的最低抑菌浓度分别为2.31微克/毫升和0.66微克/毫升。采集围手术期血样和术中组织标本进行庆大霉素和甲硝唑测定。在口服组中，血清和组织中发现了甲硝唑的有效浓度，但未检测到庆大霉素。在联合组中，检测到庆大霉素和甲硝唑的有效浓度。根据我们的结果，术前短期口服药物联合围手术期静脉注射庆大霉素和甲硝唑预防似乎是合理的。
