Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Oral Antibiotics Alone versus Oral Antibiotics Combined with Mechanical Bowel Preparation for Elective Colorectal Surgery: A Propensity Score-Matching Re-analysis of the iCral2 and iCral3 Prospective Cohorts.

Marco Catarci
* ORCID logo ,
Stefano Guadagni
ORCID logo ,
Francesco Masedu
ORCID logo ,
Massimo Sartelli
,
Leonardo Antonio Montemurro
,
Gian Luca Baiocchi
ORCID logo ,
Giovanni Domenico Tebala
ORCID logo ,
Felice Borghi
,
Pierluigi Marini
,
Marco Scatizzi
Version 1 : Received: 15 February 2024 / Approved: 16 February 2024 / Online: 16 February 2024 (07:50:08 CET)

A peer-reviewed article of this Preprint also exists.

Catarci, M.; Guadagni, S.; Masedu, F.; Sartelli, M.; Montemurro, L.A.; Baiocchi, G.L.; Tebala, G.D.; Borghi, F.; Marini, P.; Scatizzi, M.; the Italian ColoRectal Anastomotic Leakage (iCral) Study Group. Oral Antibiotics Alone versus Oral Antibiotics Combined with Mechanical Bowel Preparation for Elective Colorectal Surgery: A Propensity Score-Matching Re-Analysis of the iCral 2 and 3 Prospective Cohorts. Antibiotics 2024, 13, 235. Catarci, M.; Guadagni, S.; Masedu, F.; Sartelli, M.; Montemurro, L.A.; Baiocchi, G.L.; Tebala, G.D.; Borghi, F.; Marini, P.; Scatizzi, M.; the Italian ColoRectal Anastomotic Leakage (iCral) Study Group. Oral Antibiotics Alone versus Oral Antibiotics Combined with Mechanical Bowel Preparation for Elective Colorectal Surgery: A Propensity Score-Matching Re-Analysis of the iCral 2 and 3 Prospective Cohorts. Antibiotics 2024, 13, 235.

Abstract

Evidence regarding the role of oral antibiotics (oA) alone or combined with mechanical bowel preparation (MoABP) for elective colorectal surgery remains controversial. A prospective database of 8,359 colorectal resections gathered over a 32-month period in 78 Italian surgical units (the iCral 2 and 3 studies), reporting patient-, disease-, and procedure-related variables together with 60-day adverse events, was re-analyzed to identify a subgroup of 1,013 cases (12.1%) that received either oA or MoABP. This dataset was analyzed using a 1:1 propensity score-matching model including 20 covariates. Two well-balanced groups of 243 patients each were obtained: group A (oA), and group B (MoABP). The primary endpoints were anastomotic leakage (AL) and surgical site infections (SSIs) rates. Group A vs. group B showed a significantly higher AL risk [14 (5.8%) vs 6 (2.5%) events; OR 3.77; 95%CI 1.22-11.67; p = .021], while no significant difference was recorded between the two groups regarding SSIs. These results strongly support the use of MoABP for elective colorectal resections.

Keywords

Colorectal surgery; Mechanical bowel preparation; Oral antibiotics; Anastomotic leakage; Surgical site infections; Morbidity

Subject

Medicine and Pharmacology, Surgery

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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