608 Oral Antibiotic Bowel Preparation in Elective Anterior Resection

Abstract

Abstract Aim A single centre retrospective cohort study investigating the impact of oral antibiotic prophylaxis (OAP) for lower anterior resections on length of hospital stay and post-operative complications. Method The pre-intervention group were all elective anterior resections between 2015 and 2016. They received mechanical bowel preparation only. The intervention group were patients undergoing elective anterior resection between 2020 and 2021. These patients were given OAP in addition to standard mechanical bowel preparation. Outcomes investigated were surgical site infections, overall length of hospital stay, anastomotic leak and return to theatre. These were then compared between the two cohorts and statistical analysis was conducted. Results The pre-intervention group consisted of 221 patients and there were 201 patients in the intervention group. 61% of patients were male, whilst other patient demographics were comparable between cohorts. The mean length of hospital stay was reduced by 26.4% (p = 0.002) and the median length of stay was reduced by one day. There was a 1.5% decrease (p = 0.50) in post-operative infections, a decrease of 26.7% (p = 0.25) in anastomotic leaks and a decrease of 45% (p = 0.13) in patients who returned to theatre. Conclusions There was a statistically significant reduction in length of hospital stay with OAP alongside mechanical preparation. Although post-operative complications such as anastomotic leaks and return to theatre were reduced, these were not statistically significant, but may still have clinical and economic importance. There is strong evidence towards the benefit of OAP reducing length of stay, which reduces cost and improves patient flow and bed capacity.