Colorectal surgery is often complicated by surgical site infections (SSIs), leading to poorer patient outcomes and increased healthcare costs.1,2,3 We aimed to understand whether IV antibiotics given between seven days before through the day after a colon or rectal surgery are associated with a change in the likelihood of a patient being diagnosed with an SSI or Methicillin-Resistant Staphylococcus aureus (MRSA) infection, an antibiotic-resistant strain of bacteria.
We studied 359,987 colon surgeries and 81,605 rectal surgeries performed between January 1, 2017, and March 14, 2024. We adjusted for patient factors such as age, sex, BMI classification, smoking history, history of diabetes, social vulnerability quartile, whether the surgery was preceded by an emergency department or urgent care visit, and whether the surgery was scheduled or traumatic.
We found that patients who received IV antibiotics had a 12% reduced likelihood of SSI after colon surgery compared to those who did not receive IV antibiotics. The use of IV antibiotics did not significantly affect the rate of postoperative MRSA infections for colon surgeries. The use of IV antibiotics also did not significantly affect the rate of postoperative SSIs or MRSA infections for patients who underwent rectal surgery.
Next, we studied the relationship between SSIs or MRSA infections and whether the surgery followed a trauma. We adjusted for the same factors as the above analysis. SSI after colon surgery was twice as likely for patients who had trauma-related surgery compared to those who did not have trauma-related surgery, as seen in Figure 2. The likelihood of MRSA infection was more than tripled for this population. Similarly, among patients who underwent rectal surgery, the likelihood of an SSI or MRSA infection was more than doubled among those who had trauma-related surgery.
