Abstract
Purpose: To clarify the relationship between prophylactic antibiotics and perineal wound infection by examining the causative bacteria and risk factors for perineal wound infection following abdominoperineal resection (APR) for rectal and anal canal cancer. Methods: We examined causative bacteria in 43 patients given a diagnosis of perineal wound infection among 173 patients who underwent APR between October 2002 and November 2013. The prophylactic antibiotic given during this period was cefmetazole (CMZ), which was converted to ampicillin/sulbactam (ABPC/SBT) from November 2013. Next, we analyzed risk factors for perineal wound infection in 203 patients treated between October 2002 and April 2015 through univariate and multivariate analyses. Results: The most common causative bacteria in perineal wound infections were Staphylococcus species in 72.1% of cases, followed by Enterococcus species, which are not susceptible to CMZ, in 34.9%. The incidence of perineal wound infection caused by the type of prophylactic antibiotic was found in 43 patients (24.9%) in the CMZ group and 3 patients (10.0%; P=0.097) in the ABPC/SBT group, indicating a lower tendency in the latter group. The results of multivariate analysis identified age (≥70 years), diabetes (present), and prophylactic antibiotics (CMZ group) as independent risk factors for perineal wound infection. Conclusions: Our findings suggest that the prophylactic antibiotics ABPC/SBT suppress the onset of retroperitoneal space infection to a greater degree than CMZ following APR.
