surgery without antibiotics

[maryinflorida]

Has anyone here convinced their surgeon to perform an operation with limited or no use of antibiotics as profilactics instead of the usual nuke-all-germs standard surgical proceedure? I have to have some elective surgery soon and I hate to have all my good (and very expensive!) bacteria killed again. Not to mention the strong possibility of a CDiff relapse!

[cindym]

I had surgery in 2004 and due to me having cdiff they gave me one IV round of rocephin prior to surgery and no more. I did fine but did have a slight relapse 5 days after coming home. Upped the vanco and stopped it in its tracks. Many doctors are now realizing "precautionary" antibiotics should be kept to a minimum and especially in cases like ours. Talk to your doctor about it and voice your concerns. Good luck!

[Marry]

I recently had two separate carpel tunnel release surgeries and did not have antibiotics. That was the only way I would agree to have it done. Everything went well.

[Nancy1]

My husband had hernia surgery a bit over a year after I recovered from cdiff. I was concerned that he might be colonized by cdiff, because I was misdiagnosed for a month and didn't take many hygiene precautions during that time. So I talked to his surgeon. She originally wanted to give him a cephalosporin antibiotic before his surgery, which scared me a lot. But she ended up only giving him one dose of vancomycin. He did fine.

[Bobbie]

maryinflorida,
My son & I both had sinus surgery w/o pre-antibiotic. ENT told me they are not usually helpful but given as "standard medical procedure." If you want to be double sure, write "no antibiotics" on your arms & legs with magic marker. (I've done this.)

Of course, sometimes antibiotics are necessary. The "trick" is knowing when & where.

[maryinflorida]

Thanks for all the replies! I'm happy to see others had some success getting some flexibility out of their doctors. As Roy said, a colon resection is not the ideal antibiotic-free candidate for surgery but I am gathering ammunition to discuss all possibilities with my surgeon, who seems to be very open-minded (trained in Europe). And yes, my ID doctor already suggested going on Vanco during the surgery. Does anyone knows what other gut bacteria Vanco kills, besides CDiff?

[arlyed]

Mary,
I have been working in surgical day care for 17 years. I have seen an increase in the use of antibiotics over the years and have had issues with this because everyone knows that increased antibx. use is creating the superbugs that are so difficult (if not impossible )to fight off.
Most surgeons order Ancef (kefzol, cefazolin) IV given within one hour of the procedure. I don't know what type of surgery you will be having, but it would be worth discussing the possibility of foregoing antibx. Most gyn procedures except an hysterectomy don't require antibx. Most orthopedics do receive antibx , but it all depends on the surgeon. Anyone with a murmur, heart valve replacement, or history of endocarditis should have an antibiotic. Sorry this probably doesn't help much, but if I were you and the surgeon requires an antibx. I'd ask for Vanco IV; just make sure it is given over an hour time frame - if it's given too quickly the chances of a reaction increase.
Arlye

[cindym]

Prior to my surgery I asked if I could just have IV vanco and according to doc the vanco would not kill the bacteria that he was worried about and therefore he ordered the rocephin. All doctors are different but they should take the cdiff thing a lot more seriously than they did back in 2004 and be more willing to forego any unwarranted antibiotics.

[maryinflorida]

Guess what? Last week I survived intestinal surgery (colon resection) with a minimal amount of antibiotics and the only complications I had did not come from my gut at all. My surgeon agreed to do the laparoscopic surgery with only one dose each of Flagyl IV and Vanco IV just before the procedure. The surgery itself went very well. Unfortunately, I had a really bad reaction to the Flagyl (worse than usual!), plus had some problem clearing my lungs after the anesthesia and developed a low-grade fever…So, they had to get me off Flagyl and put me on an antibiotic called Tygacil. I was only on it for about a day and a half, so I’m hoping no great damage was done. I left the hospital 3 days after surgery, with no follow-up medications whatsoever and so far so good. It’s been about a week and a half and I have no fever or any other sign of infection (so far, not even Cdiff). My point: if gut surgery is doable with minimal use of antibiotics, so should be many other “cleaner” surgeries. How necessary are all these antibiotics (and other meds such as PPIs) that are routinely given to most patients? Or are we being overmedicated to death by our own healthcare system?

[fire7163]

When I had my neeck rebuilt 8 weeks ago I discussed my C-diff and antibiotics with my surgeon, who suggested a single course of iv vanco. I haven't had a issue during my recovery. There are surgeons who understand and that are willing to work with you. You just need to be upfront and talk to them about your concerns.

[Jenny]

Hi Mary,

So glad you got through your surgery with minimal complications. I guess you're probably doing all the probiotics again. You're right it so expensive, but worth the effort.

Good luck,

Jenny

[Bobbie]

maryinflorida,
Glad you recovered from your surgery w/complications.

You asked how often are antibiotics necessary during & after surgery. I am not in the medical field would imagine it depends on the case. I know if a new mother has strep B, she usually given antibiotics -- some of those who developed C. diff. wind up on this site.

I've posted this on the site many times, but here it is again:

My ENT told me that often the IV antibiotics given during surgery aren't necessary, do little (if any) good but are done as "standard protocol."

Overmedicated to death is probably an apt description.