Impact of Cefazolin on the Gastrointestinal Microflora at the Gastrointestinal Surgery

Shinji Akagi, Yoshio Takesue, Takashi Yokoyama^*, Yoshiaki Murakami, Yuji Imamura, Yujiro Yokoyama, Tetsuya Kanehiro, Hiroki Oge, Yoshihiro Sakashita and Yuichiro Matsuura

The First Department of Surgery and ^*Department of General Medicine,
The University of Hiroshima, Faculty of Medicine, School of Medicine

To assess the influence of preoperative administration of cefazolin on the intestinal flora, we analyzed changes of bacterial counts in feces obtained from seven patients who were administered 3-grams cefazolin per day for 3 days after gastrectomy. Stool samples were collected before surgery, and 3 days after cefazolin administration. There were no changes in total counts of aerobs, and in the count of Enterobacteriacease including Escherichia coli. There was a significant but slight decrease in the total count of anaerobes (p=0.0267), and each count of Bifidobacterium, Eubacterium, Lactobacillus, Veilonella and Bacteriodes decreased after administration. The degree of changes in bacterial counts of these organisms were almost similar, regardless of differences in antibiotic sensitivity among these organisms. These results suggest that the decrease of anaerobic counts was not caused by cefazolin administration, but by alteration of the intestinal environment after surgery. In the changes of resistant organisms, there were no overgrowth of Pseudomonas aeruginosa, Candida, Enterococcus, Clostolidium difficile and Methicillin resistant Staphylococcus aureus. No patient in this series experienced diarrhea. In summary, these results suggest that cefazolin did not disturb the ecological balance of the intestinal flora, and that it is appropriate for the prophylaxis of gastrointestinal surgery.

Key words
cefazolin, gastrointestinal microflora, anaerobes

Reprint requests
Shinji Akagi The First Department of Surgery Hiroshima University School of Medicine 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 JAPAN

Accepted
September 22, 1999

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