Antimicrobial Bowel Preparation for Elective Colon Surgery.

BACKGROUND

Mechanical bowel preparation continues to be a controversial subject for the pre-operative management of patients undergoing elective colon resection.

METHODS

The English literature on bowel preparation was searched to identify pertinent publications.

RESULTS

The published literature over the past 80 y confirms that mechanical bowel preparation alone does not reduce surgical site infections. However, the use of appropriate oral antibiotics following mechanical bowel preparation with pre-operative systemic antibiotics reduces rates of surgical site infections and anastomotic leaks when compared with systemic antibiotics alone.

CONCLUSIONS

Mechanical bowel preparation with pre-operative oral antibiotics and pre-operative systemic antibiotics are the standard of care for elective colon surgery. Refinement in methods of bowel preparation needs additional clinical investigations to further enhance outcomes.