cefoxitin and Crohn-Disease

The efficacy of cefoxitin or doxycycline as antibiotic prophylaxis in colorectal surgery was compared in 102 elective operations. Both drugs were used perioperatively only. Cefoxitin was used in 55 cases and doxycycline in 47. Ten patients in the cefoxitin group and 4 in doxycycline group had wound infections. Three intraabdominal abscesses were seen, one after cefoxitin and two after doxycycline prophylaxis. All three were due to anastomotic leakage. Bacteriologic studies revealed no negative ecologic effects of prophylaxis. The short-term prophylaxis used did protect against serious infectious complications. The extended spectrum of cefoxitin provided no added benefit in prophylaxis. Patients with inflammatory bowel disease treated preoperatively with salicylazosulfapyridine run a greater risk of postoperative infection in spite of the prophylaxis.

Topics: Adult; Aged; Cefoxitin; Colonic Diseases; Crohn Disease; Doxycycline; Female; Humans; Male; Middle Aged; Postoperative Complications; Prospective Studies; Random Allocation; Rectal Diseases; Sulfasalazine; Surgical Wound Infection

The introduction of ustekinumab, an interleukin [IL]12/23 p40 inhibitor, to the therapeutic armamentarium of Crohn's disease has provided a much needed treatment option for patients who have failed conventional biologics with anti-tumour necrosis factor [TNF] and anti-integrin agents. Despite targeting two major cytokine pathways, the side effect profile of ustekinumab appears to be favourable in clinical trials. In particular, the risk of tuberculosis infection was observed to be lower than in patients who have received anti-TNF agents. The risk of non-tuberculosis mycobacterium infection, however, remains unknown. Here, we report the first case of a patient with Crohn's disease who developed Mycobacterium abscessus infection while on ustekinumab treatment.

Topics: Amikacin; Anti-Bacterial Agents; Antibodies, Monoclonal, Humanized; Cefoxitin; Crohn Disease; Drug Administration Schedule; Female; Humans; Ileal Diseases; Injections, Subcutaneous; Interleukin-12 Subunit p40; Magnetic Resonance Imaging; Middle Aged; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Thigh; Treatment Outcome; Ustekinumab