Recovery of the susceptibility of isolated bacterium achieved by giving long-established antibiotics as prophylaxis against postoperative infections.
OBJECTIVE
To evaluate the effectiveness of operative antibiotic therapy we changed the antibiotics and examined the susceptibility of the postoperative infection.


METHODS
We studied 4 593 patients who underwent gastrointestinal surgery during the last 12.5 years, and examined the changes in intraoperative antibiotics, the return of bacteria isolated from infectious sites, the trends in frequency of Methicillin-resistant Staphylococcus aureus (MRSA) isolation, and changes in the antibiotic susceptibility of Pseudomonas aeruginosa and Bacterioides fragilis. We changed the antibiotics to Cefazolin (CEZ) for upper gastrointestinal tract surgery and cholecystectomy, and to Cefotiam (CTM) for colonic, liver, and pancreatic surgery. We also reduced the period of drug administration.


RESULTS
The rate of MRSA infections decreased, the rate of P. aeruginosa infections was always under 20% and the rate of B. fragilis infections increased. After the guidelines of drug susceptibility were prepared, the minimum inhibitory concentrations (MICs) of Cefsulodin (CFS) and Piperacillin (PIPC) for P. aeruginosa and of Latamoxef (LMOX) and PIPC for B. fragilis, decreased.


CONCLUSIONS
The use of antibiotics considered comparatively old for the prophylaxis of postoperative infection prevented the emergence of MRSA-like resistant strains, influenced changes in Gram-negative bacteria drug susceptibility, and led to an overall reduction in multiple drug resistance.
Kusachi
Shinya
S
Third Department of Surgery, Toho University School of Medicine, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan.
Sumiyama
Yoshinobu
Y
Arima
Yoichi
Y
Yoshida
Yuichi
Y
Nakamura
Yoichi
Y
Tanaka
Hidenori
H
Nagao
Jiro
J
Saida
Yoshihisa
Y
Watanabe
Manabu
M
Sato
Junko
J
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D018432:Drug Resistance, Multiple; D016905:Gram-Negative Bacterial Infections / Q000517:prevention & control*; D006801:Humans; D007432:Intraoperative Period; D016106:Methicillin Resistance; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000302:isolation & purification / Q000472:pathogenicity; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents