Korean J Clin Oncol.  2019 Dec;15(2):79-85. 10.14216/kjco.19015.

Patterns of antibiotics and pathogens for anastomotic leakage after colorectal cancer surgery

Affiliations
  • 1Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea. leeshdr@gmail.com

Abstract

PURPOSE
Anastomotic leakage (AL) is a type of intra-abdominal infection (IAI) which requires appropriate antibiotics with proper intervention. This study aimed to improve the appropriateness of antibiotic treatment by assessing the patterns of antibiotic treatment and resistance of pathogen profiles in patients who had AL after colorectal cancer surgery.
METHODS
From June 2006 through December 2017, the medical records of the patients who had AL after elective abdominal surgery for colorectal cancer in Kyung Hee University Hospital at Gangdong, Seoul, Korea were reviewed retrospectively. Baseline characteristics and consistence of antibiotics with culture study results were analyzed to evaluate the appropriateness of treatment.
RESULTS
Among 982 patients who underwent primary surgery for colorectal cancer, 41 (4.2%) had AL. Mean time of diagnosis of AL from surgery was 6.3 days. The most commonly used prophylactic antibiotics for the primary surgery was 2nd generation cephalosporin (66.6%). Mean duration of prophylactic antibiotics usage was 2.8 days. The most commonly used empirical antibiotics after AL occurred was piperacillin and tazobactam (32.6%). Mean duration of empirical antibiotics usage was 8.2 days. The most commonly identified pathogens were Escherichia coli and Enterococci spp. (26.8% each), and 12.2% of the "ESKAPE" pathogens were identified. Resistance to empirical antibiotics was 45.5% (10/22).
CONCLUSION
Penetration of culture study for AL after colorectal cancer surgery appeared relatively low, although the profile of pathogens isolated from the AL patients can give important clues and evidence for appropriate antibiotics use. Surgeons should pay attention in performing culture studies for IAI including AL for proper patient treatment.

Keyword

Intraabdominal infection; Antibiotics; Resistance; Colonic neoplasms; Anastomotic leakage

MeSH Terms

Anastomotic Leak*
Anti-Bacterial Agents*
Colonic Neoplasms
Colorectal Neoplasms*
Diagnosis
Escherichia coli
Humans
Intraabdominal Infections
Korea
Medical Records
Piperacillin
Retrospective Studies
Seoul
Surgeons
Anti-Bacterial Agents
Piperacillin
Full Text Links
  • KJCO
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr