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Local Application of Antibiotics and the Race for the Surface in Gastrointestinal Surgery

Matthias Kapischke, Alexandra Pries, Reinier Mutters

Med Sci Tech 2015; 56:91-99

DOI: 10.12659/MST.895973


ABSTRACT: Various guidelines in different countries do not recommend the local application of antibiotics to prevent surgical site infections. In addition, it appears to be common daily practice to apply local antibiotics in different formulations. The aim of this article is to present the protective mechanisms of the microbes in the context of the effect of local antibiotics.
The protective mechanisms of the microbes described in the scientific literature were reviewed and compiled. The pharmacological potential of various locally applicable antibiotic formulations able to breach the protection mechanisms of the pathogens was evaluated.
Local blood perfusion, biofilm development, small colony variants, and post-antibiotic effect are central mechanisms to lead microbes to victory in the “Race for the Surface”. Given the many factors that may in any way unfavorably influence tissue concentration, and therefore the efficacy of IV applied antibiotics, local antibiotics in sponge or powder formulation are a sensible application to prevent surgical site infections in gastrointestinal surgery.
The local application of antibiotics in gastrointestinal surgery has the potential to influence the “Race for the Surface” significantly towards the body’s infection defences in a favorable fashion and avoid surgical site infections.

Keywords: Anti-Infective Agents, Local, Biofilms, Surface Properties

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