Wetterfors J, Höjer H
Scand J Infect Dis Suppl. 1976(9):94-9.
A prospective randomized double-blind study on the effects of doxycycline as prophylactic antibiotic in elective colonic surgery is presented. 82 patients were evaluated. 39 were treated and 43 were controls. Mechanical cleansing of the bowel and a low residue diet for two days was routine. 200 mg doxycycline or placebo (2 capsules) were given orally 4-6 hours preoperatively and 100 mg (1 capsule) for 5 postoperative days. A significantly lower incidence of wound sepsis, intraabdominal complications and septicemia was registered in the doxycycline compared to the control group, 12.8 and 44.2 per cent respectively. After proctectomies, infections in the perineal field occurred in 3/9 and 5/10 cases in respective groups. In the doxycycline group, however, they were the only complication, whereas among the controls they were generally combined with infections in the abdominal field, 4/5. Peroperative contamination seemed to carry easier consequences in the doxycycline group. The results are discussed further. Doxycycline appears to be an excellent antibiotic for peroperative and short postoperative prophylactic use in potentially contaminated abdominal operations, not only because of its observed effects, but also when its negligible tendency to cause adverse reactions is taken into consideration. Bacterial cultures, concentrations of doxycycline in serum and tissues and their relation to infections will be accounted for and discussed in a separate paper.
本文介绍了一项关于强力霉素作为选择性结肠手术预防性抗生素效果的前瞻性随机双盲研究。对82例患者进行了评估。39例接受治疗，43例为对照组。常规进行肠道机械清洁并采用低渣饮食两天。术前4 - 6小时口服200mg强力霉素或安慰剂（2粒胶囊），术后5天每天口服100mg（1粒胶囊）。与对照组相比，强力霉素组的伤口感染、腹腔内并发症和败血症的发生率显著降低，分别为12.8%和44.2%。在直肠切除术后，会阴区感染在两组中的发生率分别为3/9和5/10。然而，在强力霉素组中，它们是唯一的并发症，而在对照组中，它们通常与腹腔内感染合并发生，比例为4/5。在强力霉素组中，术中污染似乎带来的后果较轻。对结果进行了进一步讨论。强力霉素似乎是潜在污染性腹部手术术中及术后短期预防性使用的一种优秀抗生素，这不仅是因为其观察到的效果，还考虑到其引起不良反应的倾向可忽略不计。细菌培养、血清和组织中强力霉素的浓度及其与感染的关系将在另一篇论文中阐述和讨论。
