Orally delivered antibiotics which lower bacterial numbers decrease experimental intra-abdominal adhesions.
BACKGROUND
Postsurgical adhesion formation is a common occurrence after most surgical procedures and is still a major cause of postoperative morbidity because no satisfactory treatment or prophylaxis has yet been developed. Further elucidation of the basic mechanisms of postsurgical adhesion formation is needed. Recent studies using germfree rats have found the indigenous bowel flora to be important in the adhesive response. The present study examined whether antibiotic treatment affects intra-abdominal adhesion formation.


METHODS
Using the cecal crush model to inflict adhesions, groups of rats ( n=12) were treated with placebo or amoxicillin/clavulanic acid in the drinking water. Treatment started 3 days before operation and continued until evaluation. Adhesion scores were recorded after 7 days. Bacterial counts were made from cultures of fecal samples on operation day and at termination.


RESULTS
Amoxicillin/clavulanic acid decreased adhesion score compared to placebo. Adhesion incidence was 50% in the treatment group and 92% in the placebo group. Bacterial numbers were lower in the treatment group.


CONCLUSIONS
Antibiotic treatment which lowers bacterial numbers can decrease adhesions.
Bothin
C
C
Department of Medical Microbial Ecology, Karolinska Institute, 14186, Stockholm, Sweden. claes.bothin@nopo.sll.se
Midtvedt
T
T
Perbeck
L
L
D000005:Abdomen; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use*; D000818:Animals; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D008297:Male; D010532:Peritoneal Diseases / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D011897:Random Allocation; D051381:Rats; D011919:Rats, Inbred Strains; D000267:Tissue Adhesions / Q000517:prevention & control
D019980:Amoxicillin-Potassium Clavulanate Combination