The impact of antibiotic prophylaxis on the prevention of surgical site infections in colorectal surgery: A critical review of the literature
DOI:
https://doi.org/10.33448/rsd-v14i3.48247Keywords:
Prophylaxis; Antibiotic prophylaxis; Surgical site infection; Colorectal surgery.Abstract
Surgical site infections (SSI) are common complications in colorectal surgeries, increasing morbidity and hospital costs. Surgical antibiotic prophylaxis (SAP) is an essential measure to prevent these infections, with its effectiveness depending on the choice of antibiotic, timing of administration, and adherence to protocols. This study, an integrative literature review, analyzed the effectiveness of the main antibiotics used in SSI prophylaxis in colorectal surgeries. Eight articles published between 2020 and 2024 were selected from the PubMed, SciELO, and Google Scholar databases using specific descriptors. The results indicated that the combination of oral and intravenous prophylaxis, particularly with nitroimidazoles (ornidazole, metronidazole), aminoglycosides (neomycin), macrolides (erythromycin), and cephalosporins (cefoxitin, ceftriaxone), significantly reduced SSI rates, especially in colon surgeries. However, prolonged prophylaxis did not show additional benefits and may delay postoperative recovery. The implementation of multifaceted preventive protocols, such as bundles, proved effective in reducing SSI, but adherence to preventive measures and monitoring of antimicrobial resistance are crucial. It is concluded that antibiotic prophylaxis is an essential strategy in preventing SSI in colorectal surgeries and should be personalized according to patient and procedural characteristics, ensuring a balance between efficacy and safety.
References
Agência Nacional de Vigilância Sanitária. (2017). Critérios diagnósticos de infecção relacionada à assistência à saúde. Brasília, DF: Autor.
Anima. (2014). Manual revisão bibliográfica sistemática integrativa: a pesquisa baseada em evidências. Grupo Anima. https://biblioteca.cofen.gov.br/wp-content/uploads/2019/06/manual_revisao_bibliografica-sistematica-integrativa.pdf.
Arezzo, A., Mistrangelo, M., Bonino, M. A., Salusso, P., Forcignanò, E., Vettoretto, N., ... & Morino, M. (2021). Oral neomycin and bacitracin are effective in preventing surgical site infections in elective colorectal surgery: a multicentre, randomized, parallel, single-blinded trial (COLORAL-1). Updates in surgery, 73, 1775-1786.
Crossetti, M. G. M. (2012). Revisión integradora de la investigación en enfermería el rigor científico que se le exige. Rev. Gaúcha Enferm. 33 (2): 8-9.
Flores-Yelamos, M., Gomila-Grange, A., Badia, J. M., Almendral, A., Vázquez, A., Parés, D., ... & Juvany, M. (2024). Comparison of two bundles for reducing surgical site infection in colorectal surgery: multicentre cohort study. BJS open, 8(4), zrae080.
Futier, E., Jaber, S., Garot, M., Vignaud, M., Panis, Y., Slim, K., ... & Paugam-Burtz, C. (2022). Effect of oral antimicrobial prophylaxis on surgical site infection after elective colorectal surgery: multicentre, randomised, double blind, placebo controlled trial. bmj, 379.
Haddaway, N. R., Page, M. J., Pritchard, C. C., & McGuinness, L. A. (2022). PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis Campbell Systematic Reviews, 18, e1230.
Lopes, C. M., & Turrini, R. N. T. (2013). Revisão integrativa: o que é e como fazer. Einstein, 8(1), 102-106.
Mattos, P. C. (2015). Tipos de revisão de literatura. Unesp, 1-9. https://www.fca.unesp.br/Home/Biblioteca/tipos-de-evisao-de-literatura.pdf.
Mulder, T., Kluytmans-van den Bergh, M., Vlaminckx, B., Roos, D., de Smet, A. M., de Vos tot Nederveen Cappel, R., ... & Kluytmans, J. (2020). Prevention of severe infectious complications after colorectal surgery using oral non-absorbable antimicrobial prophylaxis: results of a multicenter randomized placebo-controlled clinical trial. Antimicrobial Resistance & Infection Control, 9, 1-11.
Oliveira, M. A. (2012). Infecção de sítio cirúrgico: medidas de prevenção e antibioticoprofilaxia (Monografia de Especialização). Universidade Federal de Minas Gerais, Belo Horizonte.
Papp, G., Saftics, G., Szabó, B. E., Baracs, J., Vereczkei, A., Kollár, D., ... & Bursics, A. (2021). Systemic versus Oral and Systemic Antibiotic Prophylaxis (SOAP) study in colorectal surgery: prospective randomized multicentre trial. British Journal of Surgery, 108(3), 271-276.
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Editora UAB/NTE/UFSM.
Ribeiro, J. (2008). Infecção de sítio cirúrgico: medidas de prevenção e antibioticoprofilaxia. APUA-BRASIL: Aliança para o Uso Prudente de Antibióticos.
Rybakov, E., Nagudov, M., Sukhina, M., & Shelygin, Y. (2021). Impact of oral antibiotic prophylaxis on surgical site infection after rectal surgery: results of randomized trial. International Journal of Colorectal Disease, 36, 323-330.
Sica, G. S., Siragusa, L., Pirozzi, B. M., Sorge, R., Baldini, G., Fiorani, C., ... & Franceschilli, M. (2024). Gastrointestinal functions after laparoscopic right colectomy with intracorporeal anastomosis: a pilot randomized clinical trial on effects of abdominal drain, prolonged antibiotic prophylaxis, and D3 lymphadenectomy with complete mesocolic excision. International Journal of Colorectal Disease, 39(1), 102.
Sicuti, N. (2018). Antibioticoprofilaxia em procedimentos cirúrgicos: uma revisão da literatura (Trabalho de Conclusão de Curso). Instituto Nacional de Ensino Superior e Pesquisa, São Paulo.
Silva, R. F. (2009). Construindo padrões de qualidade para prevenção e controle de infecção em cirurgias ortopédicas: possibilidades e flexibilidades para a prática de enfermagem (Dissertação de Mestrado). Universidade Federal de Santa Catarina, Florianópolis.
Souza, I. S. B., de Santana, A. C., & Júnior, G. D. A. (2018). A ocorrência de infecção do sítio cirúrgico: um estudo de revisão. Rev Med Minas Gerais, 28(Supl 5), S280521.
Vadhwana, B., Pouzi, A., Surjus Kaneta, G., Reid, V., Claxton, D., Pyne, L., ... & Groot-Wassink, T. (2020). Preoperative oral antibiotic bowel preparation in elective resectional colorectal surgery reduces rates of surgical site infections: a single-centre experience with a cost-effectiveness analysis. The Annals of The Royal College of Surgeons of England, 102(2), 133-140.
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Copyright (c) 2025 Ian Oliveira Dias; Maria Eduarda Andrade Rogério; Gabriela Tavares Freitas; Mariana Ribeiro Gonçalves de Souza; Isadora Habel Figueiredo; Túlio Paulo Souza Louzano; Livya Lima de Oliveira; Luísa Martins Leal de Carvalho Neves; Rachel Gava Chaves; Elissa Paulino Silva; Isabela Fontanella de Quadra; Kamilly Valverde Magalhães; Júlia Zini Simões Alves
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