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Peer review report 1 on “The effects of preoperative oral antibiotic use on the development of surgical site infection after elective colorectal resections: A retrospective cohort analysis in consecutively operated 90 patients retrospective cohort study”
International Journal of Surgery 25 (2016) 401
Contents lists available at ScienceDirect
International Journal of Surgery journal homepage: www.journal-surgery.net
Peer Review Report
Peer review report 1 on “The effects of preoperative oral antibiotic use on the development of surgical site infection after elective colorectal resections: A retrospective cohort analysis in consecutively operated 90 patients retrospective cohort study”
1. Original submission 1.1. Recommendation Minor revision. 1.2. Comments to the author Review of IJS-D-16-00417. The authors report a cohort study of 90 patients who received or did not receive oral antibiotics prior to colon/rectal surgery. The study is interesting, but it is not clear that the information presented adds new information to the literature. The manuscript could be strengthened and upon careful review I suggest the authors consider the following: 1. How were patients chosen to be in group A or B? It is not stated that patients were assigned randomly and the reader is left wondering why. Could the group assignment method have introduced bias? 2. The use of 5 days of parenteral antibiotics post-operatively is unusual and generally not recommended currently especially due to concerns regarding development of resistant bacteria. The authors refer to three articles in the discussion that did use post-operative antibiotics but should justify their use and comment further on the risks.
DOI of published article: http://dx.doi.org/10.1016/j.ijsu.2016.07.060. http://dx.doi.org/10.1016/j.ijsu.2016.11.100 1743-9191
3. The use of an independent surgeon to evaluate patients for infection is a strong aspect of the study, but authors should clarify if this was just outpatient or throughout the entire postop period. 4. Why was the operative time in group A significantly shorter than group B? Was there any analysis of operative time and relationship to infection? 5. The description of superficial SSI and the subdivision into superficial and deep is confusing to the reader (page 5 paragraph 3). If all SSI cultures were negative, do the authors believe all were really infections? Could some have been fat necrosis? 6. How much of the increased group B cost was due to the first operation? Can the authors elaborate on how much cost infections accounted for? 7. There are some updated publications on this topic, for example the review by Zelhart MD, et al. “Preoperative Antibiotic Colon Preparation: Have We Had the Answer All Along?”, J Am Coll Surg. 2014; 219:1070e1077. The authors may find additional information to strengthen their discussion.
Anonymous reviewer
Available online 2 December 2016
Contents lists available at ScienceDirect
International Journal of Surgery journal homepage: www.journal-surgery.net
Peer Review Report
Peer review report 1 on “The effects of preoperative oral antibiotic use on the development of surgical site infection after elective colorectal resections: A retrospective cohort analysis in consecutively operated 90 patients retrospective cohort study”
1. Original submission 1.1. Recommendation Minor revision. 1.2. Comments to the author Review of IJS-D-16-00417. The authors report a cohort study of 90 patients who received or did not receive oral antibiotics prior to colon/rectal surgery. The study is interesting, but it is not clear that the information presented adds new information to the literature. The manuscript could be strengthened and upon careful review I suggest the authors consider the following: 1. How were patients chosen to be in group A or B? It is not stated that patients were assigned randomly and the reader is left wondering why. Could the group assignment method have introduced bias? 2. The use of 5 days of parenteral antibiotics post-operatively is unusual and generally not recommended currently especially due to concerns regarding development of resistant bacteria. The authors refer to three articles in the discussion that did use post-operative antibiotics but should justify their use and comment further on the risks.
DOI of published article: http://dx.doi.org/10.1016/j.ijsu.2016.07.060. http://dx.doi.org/10.1016/j.ijsu.2016.11.100 1743-9191
3. The use of an independent surgeon to evaluate patients for infection is a strong aspect of the study, but authors should clarify if this was just outpatient or throughout the entire postop period. 4. Why was the operative time in group A significantly shorter than group B? Was there any analysis of operative time and relationship to infection? 5. The description of superficial SSI and the subdivision into superficial and deep is confusing to the reader (page 5 paragraph 3). If all SSI cultures were negative, do the authors believe all were really infections? Could some have been fat necrosis? 6. How much of the increased group B cost was due to the first operation? Can the authors elaborate on how much cost infections accounted for? 7. There are some updated publications on this topic, for example the review by Zelhart MD, et al. “Preoperative Antibiotic Colon Preparation: Have We Had the Answer All Along?”, J Am Coll Surg. 2014; 219:1070e1077. The authors may find additional information to strengthen their discussion.
Anonymous reviewer
Available online 2 December 2016