Individualized Prophylaxis in Patients with Esophageal Replacement Because of Cancer

Background: Presented are the findings from an analysis of respiratory inflammatory complications in patients undergoing esophageal replacement because of cancer. Respiratory complications are manifested most frequently within five post-operative days, thus, they are likely to be caused by potentially pathogenic micro-organisms originating from the primary or secondary microflora. Methods: Sputum samples were collected 1-2wks pre-operatively. In cases of positive microbiologic finding of some potential pathogens, individualized antibiotic prophylaxis was designed. Results: Patients with individualized prophylaxis had fewer respiratory complications (10%) than patients with general antibiotic prophylaxis (41%). Conclusions: The approach to pre-operative sputum tests should be changed. If culture results are positive for bacteria with high resistance to antimicrobial agents or yeasts, the so-called individualized prophylaxis based on these particular results should be used.