Hoejer H, Wetterfors J
Scand J Gastroenterol Suppl. 1980;59:5-9.
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.
在一项前瞻性随机研究中，评估了强力霉素预防性治疗对择期结直肠手术中额外使用抗菌药物及术后住院时间的影响。在该研究中，腹部脓毒症的发生率从对照组的45%显著降至强力霉素组的12.1%。还报告了随后一项全面系列研究的结果，该研究中在择期肠道手术中常规使用了预防性治疗。使用预防性治疗后，术后平均天数减少了7天（p<0.01）。在发生腹部脓毒症的病例中，这种差异更为显著。预防性治疗使住院时间延长了7天，而未进行预防性治疗的患者住院时间为22天。未进行预防性治疗时，65%的患者在术后过程中接受了抗菌治疗，而接受治疗的患者中这一比例不到20%。对照组患者的抗菌药物暴露时间比接受预防性治疗的患者更长。因此，预防性治疗显著降低了腹部脓毒症的发生率、术后护理时间和需求、抗菌药物的总使用量及暴露时间。此外，在广泛使用强力霉素的四年中未观察到微生物紊乱。
