The American Journal of Surgery
Volume 193, Issue 2 , Pages 190-194, February 2007

Polyethylene glycol versus sodium phosphate mechanical bowel preparation in elective colorectal surgery

  • Kamal M.F. Itani, M.D.

      Affiliations

    • VA Boston Healthcare System and Boston University School of Medicine, 1400 VFW Pkwy. (112), West Roxbury, MA 02132, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1-857-203-6205; fax: +1-857-203-5549.
    • ,
  • Samuel E. Wilson, M.D.

      Affiliations

    • University of California, Irvine, School of Medicine, Orange, CA, USA
    • ,
  • Samir S. Awad, M.D.

      Affiliations

    • Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, USA
    • ,
  • Erin H. Jensen, M.S.

      Affiliations

    • Merck & Co., Inc., West Point, PA, USA
    • ,
  • Tyler S. Finn, B.A.

      Affiliations

    • Merck & Co., Inc., West Point, PA, USA
    • ,
  • Murray A. Abramson, M.D., M.P.H.

      Affiliations

    • Merck & Co., Inc., West Point, PA, USA

Received 24 May 2006; received in revised form 1 August 2006

Abstract 

Background

The type of mechanical bowel preparation (MBP) used before elective colorectal surgery remains controversial.

Methods

This post hoc analysis of a prospective randomized controlled antibiotic prophylaxis trial (ertapenem vs. cefotetan) evaluated the effect of polyethylene glycol (PEG) and sodium phosphate (SP) MBPs on the rates of postoperative surgical site infections (SSI).

Results

Good to excellent MBPs were observed in 281 of 303 (93%) evaluable patients for the PEG and 336 of 367 (92%) for the SP types. A higher rate of SSI was observed in the PEG (34%) than SP (24%) group (difference, 10%; 95% confidence interval, 3.4–17.2). The MBP type was a significant risk factor for SSI, with SP favored over PEG (odds ratio, .6; 95% confidence interval, .43–.85) in univariate analysis; multivariate analysis favored SP, but was not significant (odds ratio, .69; 95% confidence interval, .46–1.02). SSI was lowest with SP and ertapenem (19%) and highest with PEG and cefotetan (44%).

Conclusions

SP, coupled with ertapenem antibiotic prophylaxis, may improve outcomes and reduce SSIs in patients undergoing elective colorectal surgery when compared with PEG coupled with cefotetan antibiotic prophylaxis.

Keywords: Mechanical bowel preparation, Polyethylene glycol, Sodium phosphate, Surgical site infection

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S0002-9610(06)00521-6

doi:10.1016/j.amjsurg.2006.08.024

The American Journal of Surgery
Volume 193, Issue 2 , Pages 190-194, February 2007

Article Tools