The prophylactic effect of systemic metronidazole on infectious complications following elective colo-rectal surgery was compared with the prophylactic effect of oxytetracycline. Allocation to ...receive metronidazole or oxytetracycline was random. A total of 137 patients were accepted for the trial, 67 receiving metronidazole and 70 oxytetracycline. The numbers of abdominal wound infections, intra-abdominal infections, fever and deaths were few in both groups, and the differences statistically insignificant. Clinically significant side effects of the antimicrobial agents were not observed. The influence of the antimicrobial agents on colonic flora was also studied. No significant difference in the effect on colonic anaerobic flora was demonstrated, whereas the aerobic flora was significantly suppressed by oxytetracycline. It is concluded that systemic metronidazole, although acting solely on the anaerobic flora, is as effective as oxytetracycline in preventing postoperative infectious complications following elective colo-rectal surgery. The prophylactic use of metronidazole is advocated.
Qualitative and quantitative examinations of the cultivable bacterial flora in biopsies from recurrent aphthous ulcerations (RAU), experimental oral ulcerations (EOU), and normal oral mucosa (NOM) ...were carried out under aerobic and continuous anaerobic conditions. An attempt was made to culture yeasts, mycoplasma, and virus from the biopsies of RAU, which were also tested for the presence of herpes virus antigen by the fluorescent antibody method. The predominant bacteria recovered in RAU were alpha-hemolytic streptococci, coagulase-negative staphylococci, and Neisseria. In EOU the main recoveries were alpha-hemolytic streptococci, Corynebacterium, Veillonella, Neisseria, and Haemophilus. In NOM alpha-hemolytic streptococci dominated the cultures. Yeasts were only cultured from one patient with RAU. No mycoplasmas or viruses were isolated, nor was herpes virus antigen demonstrated in any of the RAU specimens. The role of the microorganisms in the pathogenesis of RAU is discussed.
In 5 patients with bypass-enteropathy following jejunoileal shunt-operation for morbid obesity, bacterial overgrowth was demonstrated in the functioning small bowel. The symptoms were effectively ...relieved during treatment with metronidazole in the 3 patients, who completed the treatment. Bacterial cultures revealed no anaerobic growth during 3 of 4 periods of treatment. Anaerobic overgrowth in the small bowel is probably the cause of bypass-enteropathy following jejunoileal shunt-operation.
