On the effect on antimicrobial use and postoperative hospital stay of prophylactic treatment with doxycycline in colorectal surgery.

The effects of prophylactic treatment with doxycycline on additional antimicrobial use and on postoperative hospital stay in elective colorectal surgery were evaluated in a prospective and randomized study, where the incidence of abdominal sepsis was significantly reduced from 45% in the control to 12.1% in the doxycycline group. Results from a subsequent comprehensive series, where prophylaxis was used routinely in elective intestinal surgery are also reported. With prophylaxis the average number of postoperative days decreased with 7 days (p less than 0.01). In cases with abdominal sepsis this difference was more prominent. With prophylactic treatment it prolonged hospital stay with 7 days compared to 22 days without. Without prophylactic treatment 65% of the patients received antimicrobial treatment during the postoperative course, whereas less than 20% among the treated patients did so. The period of exposure to antimicrobials was longer in patients in the control group than among patients receiving prophylaxis. Thus prophylaxis significantly reduced the rate of abdominal sepsis, the time of and the need for postoperative nursing, the total use of and time of exposure to antimicrobials. Furthermore, microbiological disturbances have not been observed during four years of extensive use of doxycycline.