European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026
Long-term implications of using preoperative oral antibiotics to prevent surgical-site infections in colon surgery: a follow-up study from ORALEV RCT.
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Pellino Gianluca, Martínez-López María, Rudge Eleanor, Solís-Peña Alejandro, Kreisler Esther, Fraccalvieri Domenico, Muinelo-Lorenzo Manuel, Maseda Díaz Olga, García-González José María, Huguet Bernat Miguel, Codina-Cazador Antonio, Biondo Sebastiano, Espín-Basany Eloy
Аннотация
BACKGROUND: ORALEV-RCT demonstrated that preoperative oral antibiotics (OA) before colon surgery reduces surgical-site infections. There was concern regarding a potential risk of antibiotic resistance.
AIM: To assess if OA led to increased long-term infection-related complications/antibiotic resistance.
METHODS: Retrospective analysis of 3-year follow-up data of ORALEV.
PRIMARY OUTCOME: risk of infectious complications with vs without OA. Secondary: long-term complications, effect on COVID-19.
RESULTS: 529 were included (n = 265,no OA vs n = 264,OA). Infective complications with hospital admissions (2.6% vs 2.6%, no OA vs OA), antibiotic treatment (1.9% vs 1.1%,p = 0.715), and COVID-19 (0.4% vs 1.5%,p = 0.22) did not differ. Three patients required ertapenem. Readmissions for any complication did not differ (10.9% vs 12.5%,p = 0.67). After removing COVID-19 admissions, COPD was associated with need for antibiotic treatment in the long-term (HR 5.13, 95%CI 1.28-20.54) irrespective of OA administration. Postoperative hernia (4.1% vs 1.5%,p = 0.11) and indication for repair (81.8% vs 25%,p = 0.08) were higher in non-OA group, but not statistically different.
CONCLUSIONS: OA do not increase the risk of long-term infective complications and need for advanced antimicrobial treatment. COPD increased the risk of subsequent need for antibiotic treatment.
AIM: To assess if OA led to increased long-term infection-related complications/antibiotic resistance.
METHODS: Retrospective analysis of 3-year follow-up data of ORALEV.
PRIMARY OUTCOME: risk of infectious complications with vs without OA. Secondary: long-term complications, effect on COVID-19.
RESULTS: 529 were included (n = 265,no OA vs n = 264,OA). Infective complications with hospital admissions (2.6% vs 2.6%, no OA vs OA), antibiotic treatment (1.9% vs 1.1%,p = 0.715), and COVID-19 (0.4% vs 1.5%,p = 0.22) did not differ. Three patients required ertapenem. Readmissions for any complication did not differ (10.9% vs 12.5%,p = 0.67). After removing COVID-19 admissions, COPD was associated with need for antibiotic treatment in the long-term (HR 5.13, 95%CI 1.28-20.54) irrespective of OA administration. Postoperative hernia (4.1% vs 1.5%,p = 0.11) and indication for repair (81.8% vs 25%,p = 0.08) were higher in non-OA group, but not statistically different.
CONCLUSIONS: OA do not increase the risk of long-term infective complications and need for advanced antimicrobial treatment. COPD increased the risk of subsequent need for antibiotic treatment.