결장 직장암 환자의 수술에서 단기 예방적 항생제 요법의 효과

Effect of Short-term Prophylactic Antibiotics in Operation of Colorectal Cancer Patient

Purpose: The use of prophylactic antibiotics in addition to mechanical cleansing is the consensus on care prior to colorectal surgery. Traditionally the multi-dose antibiotics have been used for prophylaxis of surgical site infections (SSIs) in South Korea. Our study aim was to establish whether a short-term perioperative antibiotics are as effective as traditional multi-dose long-term antibiotics in preventing SSIs after colorectal cancer surgery. Methods: A total of 51 patients who underwent elective operation of colorectal cancer were enrolled in the prospective study from August 01, 2005 to July 31, 2006. As a control group, 27 patients were administrated with 3rd-generation cephalosporins, aminoglycosides and metronidazole for 5 days after operation parenterally and 7 days more orally. As a study group, 24 patients were administrated with cefazolin and metronidazole for prophylactic antibiotics 3 or 4 times for 24 hours after operation parenterally. Results: Each 3 SSIs developed in the short-term group (12.5%) and the long-term group (11.1%). Group D Enterococci was detected in all 6 SSIs. There was no significant difference in the incidence of SSIs between two groups (P=0.607). Other nosocomial infections (urinary tract infection and pseudomembranous colitis) developed in the long-term group. Conclusion: Prophylactic short-term antibiotics administration in elective colorectal cancer operation showed no difference of incidence of SSIs in comparison with multiple, long-term post-operative administration. This result suggests that the short-term antibiotics is effective in prophylaxis o f SSIs in the colorectal cancer operation.