Antimicrobial prophylaxis of gastrointestinal surgical procedures and treatment of XXXX .

@entity1 @entity5503 @entity801 @entity295 @entity868 @entity1661 @entity2929 @entity5821 @entity5154 @entity881 @entity1320 @entity694 @entity166 @entity3398 @entity3402 @entity3399
Antibiotic prophylaxis and treatment regimens ideally are selected on the basis of efficacy, safety, and cost. This review evaluates current, selected literature on antibiotic prophylaxis for colorectal surgery, presumptive antibiotic administration following penetrating @entity1661 , and treatment of @entity1320 . Single-drug regimens with the newer, broad-spectrum agents are assessed and compared with combination regimens; specific regimens are recommended. Colorectal procedures require an antimicrobial agent with activity against both aerobes and anaerobes. @entity1 undergoing elective colorectal procedures can be adequately protected with an orally administered three-dose regimen of @entity5154 / @entity2929 . Parenteral antibiotic administration is generally not necessary, but, @entity3398 is recommended for nonelective colorectal surgery. The risk of potential @entity166 following penetrating @entity1661 without @entity694 is less than with @entity694 ; however, antibiotic therapy that includes activity against aerobes and anaerobes is recommended for all types of penetrating @entity1661 . Although @entity5821 , @entity5503 , or @entity3398 alone may be used in @entity1661 without perforation of the colon, only @entity3398 is recommended as a single-drug alternative to the standard @entity3402 / @entity801 regimen in trauma with @entity694 . Single-drug therapy with @entity3398 or @entity3399 can be used successfully as alternatives to the standard regimens of @entity3402 / @entity801 or @entity868 / @entity801 in many @entity1 with @entity295 . Single-drug regimens reduce the risk of developing adverse effects and are cost-effective. However, if resistant organisms are suspected, or if the @entity1 has been hospitalized for a prolonged period or has @entity881 , it may be necessary to supplement @entity3398 therapy with an antibiotic that will enhance coverage against gram-negative aerobes.
