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December 1954

STUDIES ON REDUCTION OF INTESTINAL FLORA: Preoperative Treatment of Patients with Lesions of Colon or Rectum

Author Affiliations

From the University Institute of General Pathology (Head, Prof. VK. A. Jensen) and the Department of Surgery I. Kommunehospitalet (Head, Prof. O. Mikkelsen).

AMA Arch Surg. 1954;69(6):858-869. doi:10.1001/archsurg.1954.01270060100015

MARSHALL, Bratton, White, and Litchfield,1 in 1940, published a report of investigations made with sulfaguanidine, a sulfonamide showing relatively little tendency to being absorbed. Its use had enabled them to reduce the number of colibacilli in the fecal flora of mice, and they recommended it for the treatment of infectious intestinal diseases in humans.

After this, sulfaguanidine was used preoperatively to reduce the coliflora prior to surgical intervention involving the colon or rectum. There was some dissatisfaction with this remedy, however, as some of it was absorbed and its effect on the coliflora was rather uncertain.*

The synthesization and testing of succinylsulfathiazole and phthalylsulfathiazole by Moore and Miller4 and Poth and Ross,5 respectively, was therefore a considerable advance in this field. Treatment with these drugs reduced the coliflora in the feces to less than 1,000 bacteria per gram in 93% of the patients in five to seven

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