The Efficacy of Oral Antimicrobials in Reducing Aerobic and Anaerobic Colonic Mucosal Flora

• We investigated the impact of intestinal antisepsis on the colonic mucosa-associated flora. Four groups of dogs were studied: group A received no bowel preparation, group B received a three-day clear-liquid diet, group C underwent mechanical cleansing of the bowel, and group D had mechanical cleansing followed by oral neomycin and erythromycin. Mucosal biopsy specimens were obtained for bacteriologic and scanning electron microscopic (SEM) studies. No significant difference in recovery of mucosal bacteria was observed between groups A and B. A significant decrease in recovery of aerobes was observed in group C, and a significant decrease in both aerobes and anaerobes was observed in group D compared with group A; Enterobacteriaceae and Bacteroides were either eliminated or greatly reduced. The SEM analysis of group D revealed a marked decrease in mucosa-associated microflora compared with groups B and C. Oral neomycin-erythromycin produced a significant quantitative reduction in the colonic mucosa-associated bacterial population, including the potentially pathogenic Escherichia coli and Bacteroides fragilis group isolates. These mucosa-associated bacteria are a likely source of contamination of the abdominal cavity and wound at the time of colon surgery.

(Arch Surg 1989;124:281-284)