Mechanical and oral antibiotics bowel preparation reduce the risk of surgical site infections and…

Systematic reviewFrontiers in medicine· 2026

Mechanical and oral antibiotics bowel preparation reduce the risk of surgical site infections and anastomotic leakage in colorectal surgery: a GRADE-based meta-analysis and trial sequential analysis.

Kai Lu, Xuefeng Peng, Furui Zhong … Ke Lan

Colon & Rectal SurgerySystematic reviewTreatmentQ1IF 3.4

Combined mechanical and oral antibiotic bowel prep lowers odds of anastomotic leakage after colorectal surgery

Mechanical and oral antibiotics bowel preparation reduce the risk of surgical site infections and anastomotic leakage in colorectal surgery: a GRADE-based meta-analysis and trial sequential analysis.

Kai Lu … Ke Lan

Frontiers in medicine · 2026 · Q1 in General Medicine

Purpose

Recent updates from randomized controlled trials (randomized controlled trials) indicated that mechanical and oral antibiotics bowel preparation (mechanical and oral antibiotics bowel preparation) can reduce post-operative surgical site infection (surgical site infection), but its effect on anastomotic leakage (anastomotic leakage) remains controversial.

Methods

We conducted a comprehensive search of PubMed, Cochrane Library, Embase, and Web of Science for randomized controlled trials comparing mechanical and oral antibiotics bowel preparation to mechanical bowel preparation (mechanical bowel preparation) alone, from database inception to February 1, 2025.

n = 4,633 patients

Results

antibiotic prep lowers the odds of anastomotic leak

OR by subgroup · 95% CI

More results

Subgroup analyses indicated reductions in superficial surgical site infection, deep surgical site infection, space and organ infection.

Trial sequential analysis further confirmed the robustness of these findings.

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Conclusion · 1 of 2

Mechanical and oral antibiotics bowel preparation can effectively reduce the risk of surgical site infection and anastomotic leakage in colorectal surgery.

Conclusion · 2 of 2

Pre-operative bowel preparation should consider incorporating oral antibiotics to optimize surgical outcomes.

Mechanical and oral antibiotics bowel preparation reduce the risk of surgical site infections and anastomotic leakage in colorectal surgery: a GRADE-based meta-analysis and trial sequential analysis.

Mechanical and oral antibiotics bowel preparation reduce the risk of surgical site infections and anastomotic leakage in colorectal surgery: a GRADE-based meta-analysis and trial sequential analysis.

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