Do topical antibiotics provide improved prophylaxis against bacterial growth in the presence of polypropylene mesh?
BACKGROUND
Herniorrhaphies using a foreign body such as mesh can become infected. An experiment was performed in rabbits to compare three methods of antibiotic treatment to prevent the growth of bacteria in mesh-containing wounds.


METHODS
This experiment compared preoperative intravenous antibiotics (cefazolin), topical antibiotics applied intraoperatively (bacitracin), and their combination in preventing the quantitative growth of bacteria in a subcutaneous wound containing a polypropylene mesh inoculated with Staphylococcus aureus. The bacteria were inoculated in doses sufficient to deliberately cause the growth of 130.0 +/- 56.4 x 10(4) bacteria per gram of tissue in saline-treated control animals. Quantitative cultures of the mesh and surrounding tissues were obtained 5 days after insertion of the mesh and inoculation of the wound.


RESULTS
Experimental data showed that treatment with systemic intravenous antibiotics, topical powdered antibiotics, or their combination all statistically significantly decreased the quantitative cultures grown from the inoculated tissues as compared with saline-treated controls (P<0.05). However, there were no statistically significant differences in quantitative growth among the three methods of antibiotic treatment.


CONCLUSIONS
Antibiotics reduced the quantitative growth of bacteria in tissues excised from wounds inoculated with bacteria. However, preoperative intravenous antibiotics, topical powdered antibiotics, and their combination all were equally effective.
Troy
M G
MG
Department of Surgery, Loyola University Medical Center, Maywood, Illinois, USA.
Dong
Q S
QS
Dobrin
P B
PB
Hecht
D
D
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage* / Q000494:pharmacology; D019072:Antibiotic Prophylaxis; D001414:Bacitracin / Q000008:administration & dosage* / Q000494:pharmacology; D001431:Bacteriological Techniques; D002437:Cefazolin / Q000008:administration & dosage* / Q000494:pharmacology; D002511:Cephalosporins / Q000008:administration & dosage* / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D007275:Injections, Intravenous; D011126:Polypropylenes; D011817:Rabbits; D013211:Staphylococcus aureus / Q000187:drug effects / Q000254:growth & development; D013526:Surgical Mesh; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D002511:Cephalosporins; D011126:Polypropylenes; D001414:Bacitracin; D002437:Cefazolin