Adding Preoperative Oral Antibiotics to Mechanical Bowel Preparation Reduces Surgical Site Infections in…

Meta-analysisMedicina (Kaunas, Lithuania)· Jun 2026

Adding Preoperative Oral Antibiotics to Mechanical Bowel Preparation Reduces Surgical Site Infections in Elective Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials.

Héctor Guadalajara, Alicia Putan, Mariano García Arranz … Damián García-Olmo

Colon & Rectal SurgeryMeta-analysisTreatmentQ4IF 0.1

Adding oral antibiotic bowel prep to mechanical prep lowers odds of surgical site infection.

Adding Preoperative Oral Antibiotics to Mechanical Bowel Preparation Reduces Surgical Site Infections in Elective Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials.

Héctor Guadalajara … Damián García-Olmo

Medicina (Kaunas, Lithuania) · Jun 2026 · Q4 in General Medicine

Background

Surgical site infections (surgical site infections) remain common after elective colorectal surgery.

Methods

PubMed, the Cochrane Library, Scopus, and ClinicalTrials.gov were searched for English-language randomized controlled trials published from January 2005 to January 2025.

n = 4073 patients

Results

adding oral antibiotics to bowel prep lowers surgical site infection odds

OR by subgroup · 95% CI

More results

The effect was preserved in metronidazole-containing regimens (OR 0.46, 95% CI 0.33-0.65), but this subgroup was exploratory.

Excluding high-risk-of-bias studies supported the primary result.

Publication-bias assessment was underpowered.

More results

Overall and organ-space surgical site infections were moderate-certainty outcomes; incisional surgical site infections was low-certainty, and anastomotic leak was very low-certainty.

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Conclusion · 1 of 2

In contemporary elective colorectal surgery when mechanical bowel preparation is used, adding preoperative OAB probably reduces surgical site infections.

Conclusion · 2 of 2

Findings do not establish whether OAB alone is sufficient or whether mechanical bowel preparation is necessary; stewardship-relevant outcomes remain insufficiently reported. Funding was provided by ISCIII grant PI25/01285.

Adding Preoperative Oral Antibiotics to Mechanical Bowel Preparation Reduces Surgical Site Infections in Elective Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials.

Adding Preoperative Oral Antibiotics to Mechanical Bowel Preparation Reduces Surgical Site Infections in Elective Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials.

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