Sixty-two patients were admitted to a prospective randomized controlled trial to investigate the influence of a prophylactic
antibiotic,
lincomycin, on anaerobic
sepsis following bowel surgery. The incidence of postoperative
sepsis was reduced from 45 to 18 per cent (P less than 0-025).
Wound infections were reduced from 38 to 12 percent (P less than 0-05). Intra-abdominal or pelvic
abscess occurred in 1 of the treated group compared with 3 controls. Septicaemia occurred after operation in 1 patient receiving
lincomycin and in 3 of the controls; in 2 of the latter, pure growths of bacteroides were isolated from the blood cultures and 1 of these patients died. Although
lincomycin had no influence on the number of patients who developed aerobic postoperative
infections, there was a significant reduction in the incidence of
sepsis due to bacteroides, which occurred in 10 of the control group compared with 1 in the
lincomycin group (P less than 0-005). No patients developed complications attributable to
lincomycin, such as
pseudomembranous colitis. These data indicate that the genus Bacteroides are important pathogenic organisms and are responsible for postoperative morbidity. Furthermore, anaerobic
sepsis can be reduced by appropriate prophylactic
antibiotics.