Tudor R G
Department of Surgery, Queen Elizabeth Hospital, Birmingham.
J Hosp Infect. 1991 Sep;19 Suppl C:71-6. doi: 10.1016/0195-6701(91)90170-d.
The major advances in antibiotic prophylaxis in colorectal surgery have come from an awareness of the need for appropriate agents against the known likely pathogens and from knowledge of the pharmacokinetics of these drugs. Intensive study has been undertaken to identify optimal regimens, but as there is great variability in the settings under which these operations take place, it is not always possible to compare the results of these various investigations. There is little doubt that in many cases there is gross contamination with faecal organisms and the term prophylaxis is inappropriate so that prolonged courses of antibiotics would appear to be safer. However, work towards identifying patients at increased susceptibility of developing septic complications may well further improve the outcome of colorectal surgery.
结直肠手术中抗生素预防的主要进展源于对使用合适药物对抗已知可能病原体的必要性的认识，以及对这些药物药代动力学的了解。人们进行了深入研究以确定最佳方案，但由于这些手术开展的环境差异很大，所以并不总是能够比较这些不同研究的结果。毫无疑问，在许多情况下存在粪便微生物的严重污染，“预防”这个术语并不恰当，因此延长抗生素疗程似乎更安全。然而，致力于识别发生脓毒症并发症易感性增加的患者，很可能会进一步改善结直肠手术的预后。
