Schneiders H, Haralambie E, Towfigh H, Eigler F W, Linzenmeier G
Chirurg. 1976 Jan;47(1):33-8.
The value of preoperative bowel preparation with antibiotics in colon surgery was studied in a prospective randomized trial: 58 patients received only mechanical and dietary preparation and 50 patients were treated additionally with a combination of neomycin and bacitracin 4 days preoperatively. Bacteriologic studies of stools from the day before beginning of preparation and from the day before surgery which were done quantitatively per 1 gram stool revealed that the fecal flora of 90% of the patients with colonic disease is abnormal. After antibiotic treatment a significant reduction of Escherichia coli, Bacteroides, Bifidus, Clostridium, and Proteus was obtained in more than 70% of the patients. The effect on Klebsiella was poor. Candida were increased in 86% of the cases without resulting in a systemic candida infection. In the stool samples of 16 patients no bacteria were found after antibiotic treatment. If there was a high bacterial count in the preoperative stool infectious complications followed postoperatively. The rate of infectious complications was 28 (48.7%) in the control group and 7 (14%) in the antibiotic group. This significant lower rate of complications speaks in favor of preoperative bowel preparation with neomycin and bacitracin, especially in the absence of adverse side-effects.
在一项前瞻性随机试验中，研究了结肠手术前使用抗生素进行肠道准备的价值：58例患者仅接受机械和饮食准备，50例患者在术前4天额外接受新霉素和杆菌肽联合治疗。对准备开始前一天和手术前一天的粪便进行细菌学研究，每1克粪便进行定量分析，结果显示90%的结肠疾病患者粪便菌群异常。抗生素治疗后，70%以上的患者大肠杆菌、拟杆菌、双歧杆菌、梭菌和变形杆菌显著减少。对克雷伯菌的效果较差。86%的病例念珠菌增加，但未导致全身性念珠菌感染。16例患者的粪便样本在抗生素治疗后未发现细菌。如果术前粪便中细菌计数较高，则术后会出现感染性并发症。对照组感染性并发症发生率为28例（48.7%），抗生素组为7例（14%）。这种显著较低的并发症发生率表明术前使用新霉素和杆菌肽进行肠道准备是有益的，尤其是在没有不良副作用的情况下。
