title: Preoperative oral and postoperative parenteral antibiotic prophylaxis of wound infection in total cystectomy with ileal urinary diversion.
abstract: We describe an investigation of postoperative abdominal infectious complications and discuss two regimens for preoperative antibiotic bowel preparation in cases who underwent total cystectomy with ileal urinary diversion. Ten cases (28.6%) of 35 who had been operated developed abdominal infectious complications. Six showed abdominal wound infection, 2 showed intrapelvic abscess and 2 showed abdominal wound infection with intrapelvic abscess. Of the 19 strains of organisms isolated from the postoperative infections, 11 (57.9%) were anaerobic bacteria and the most commonly isolated bacteria was Bacteroides. A significantly lower incidence of postoperative infection was found in cases who had received tobramycin and vancomycin (0%) than in those who had received kanamycin alone (41.7%). These results indicate that anaerobic bacteria are the major contributors to postoperative infections following total cystectomy with ileal urinary diversion and that tobramycin-vancomycin prophylaxis greatly reduces the incidence of postoperative infections.
authors.affiliation: Department of Urology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Matsumoto
authors.forename: N
authors.initials: N
authors.lastname: Ogata
authors.forename: S
authors.initials: S
authors.lastname: Masuda
authors.forename: J
authors.initials: J
authors.lastname: Kumazawa
mesh_terms: D000005:Abdomen; D000038:Abscess / Q000209:etiology; D000284:Administration, Oral; D001420:Bacteria, Aerobic / Q000302:isolation & purification; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control; D015653:Cystectomy / Q000009:adverse effects*; D005260:Female; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D007082:Ileum / Q000601:surgery; D007263:Infusions, Parenteral; D007612:Kanamycin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology; D011182:Postoperative Care; D011292:Premedication; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D014547:Urinary Diversion / Q000009:adverse effects*
chemical_list: D007612:Kanamycin