title: The role of oral antibiotics prophylaxis in prevention of surgical site infection in colorectal surgery.
abstract: BACKGROUND
  Surgical site infection (SSI) continues to be a challenge in colorectal surgery. Over the years, various modalities have been used in an attempt to reduce SSI risk in elective colorectal surgery, which include mechanical bowel preparation before surgery, oral antibiotics and intravenous antibiotic prophylaxis at induction of surgery. Even though IV antibiotics have become standard practice, there has been a debate on the exact role of oral antibiotics.
  
  
  OBJECTIVE
  The primary aim was to identify the role of oral antibiotics in reduction of SSI in elective colorectal surgery. The secondary aim was to explore any potential benefit in the use of mechanical bowel preparation (MBP) in relation to SSI in elective colorectal surgery.
  
  
  METHODS
  Medline, Embase and the Cochrane Library were searched. Any randomised controlled trials (RCTs) or cohort studies after 1980, which investigated the effectiveness of oral antibiotic prophylaxis and/or MBP in preventing SSIs in elective colorectal surgery were included.
  
  
  RESULTS
  Twenty-three RCTs and eight cohorts were included. The results indicate a statistically significant advantage in preventing SSIs with the combined usage of oral and systemic antibiotic prophylaxis. Furthermore, our analysis of the cohort studies shows no benefits in the use of MBP in prevention of SSIs.
  
  
  CONCLUSIONS
  The addition of oral antibiotics to systemic antibiotics could potentially reduce the risk of SSIs in elective colorectal surgery. Additionally, MBP does not seem to provide a clear benefit with regard to SSI prevention.
authors: School of Medicine, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZN, UK.
authors: Michalis
authors: M
authors: Koullouros
authors: School of Medicine, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZN, UK.
authors: Nadir
authors: N
authors: Khan
authors: School of Medicine, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZN, UK. emad.aly@nhs.net.|Laparoscopic Colorectal Surgery and Training Unit, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK. emad.aly@nhs.net.
authors: Emad H
authors: EH
authors: Aly
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D003107:Colorectal Surgery / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017594:Publication Bias; D011785:Quality Assurance, Health Care; D016032:Randomized Controlled Trials as Topic; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Colorectal surgery; Prophylaxis; Wound site infection