The efficacy of prophylactic administration of SBT/ABPC for preventing surgical site infection in elderly patients undergoing colorectal surgery.

BACKGROUND/AIMS: Colorectal surgery presents a high risk of surgical site infections (SSI). SSI and prolonged hospital stay were associated with being aged 75 years or older. We investigated the efficacy of sulbactam sodium/ampicillin sodium (SBT/ABPC), which is a combination drug of ampicillin and beta-lactamase inhibitor, as a prophylactic drug against SSI in elderly patients undergoing colorectal surgery.

METHODOLOGY: From July 2003 to November 2005, a total of 181 patients underwent colorectal surgery. Of these patients, 43 who were older than 75 years were compared with 138 who were younger. Patients were given SBT/ABPC as follows: Before anesthetic induction at surgery, 1.5 g of SBT/ABPC was administrated by intravenous drip infusion, and further doses were continued at 12-hour intervals for 2 days. We assessed SSI, postoperative stay, type of surgery, duration of operation, and amount of bleeding.

RESULTS: The result was that SSI was found in none of the patients. There was no significant difference in rate of SSI and postoperative hospital stay between the two groups. Adverse reactions due to SBT/ABPC such as apparent skin symptoms or gastrointestinal symptoms were not observed.

CONCLUSIONS: SBT/ABPC for elderly patients would be effective to prevent SSI in colorectal operations and could be used safely.