Individualized Prophylaxis in Patients with Esophageal Replacement Because of Cancer.

BACKGROUND

Presented are the findings from an analysis of respiratory inflammatory complications in patients undergoing esophageal replacement because of cancer. Respiratory complications are manifested most frequently within five post-operative days, thus, they are likely to be caused by potentially pathogenic micro-organisms originating from the primary or secondary microflora.

METHODS

Sputum samples were collected 1-2 wks pre-operatively. In cases of positive microbiologic finding of some potential pathogens, individualized antibiotic prophylaxis was designed.

RESULTS

Patients with individualized prophylaxis had fewer respiratory complications (10%) than patients with general antibiotic prophylaxis (41%).

CONCLUSIONS

The approach to pre-operative sputum tests should be changed. If culture results are positive for bacteria with high resistance to antimicrobial agents or yeasts, the so-called individualized prophylaxis based on these particular results should be used.