New advances in antibiotic prophylaxis for colorectal surgery.

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.