From the Research
Patients who undergo total colonectomy have a slightly increased risk of fungal infections, primarily Candida species, due to several factors, and preventive measures such as proper wound care and completing the full course of prescribed antibiotics are crucial. The risk is highest in the immediate postoperative period, especially in immunocompromised patients or those receiving broad-spectrum antibiotics. Some key factors to consider include:
- Surgical disruption of the gastrointestinal tract can alter the normal microbial balance
- The stress of surgery and potential nutritional deficiencies can temporarily suppress immune function
- The use of antibiotics to prevent bacterial infections can inadvertently promote fungal overgrowth by eliminating competing bacteria According to the most recent and highest quality study 1, caspofungin, rezafungin, and micafungin are considered the most promising therapies for treating candidemia, with higher rates of clinical and mycological responses. For high-risk patients, prophylactic antifungal medications like fluconazole may be considered, though this is not routine practice for all patients 1. If a fungal infection develops, treatment typically involves topical antifungals for superficial infections or systemic therapy with fluconazole for more severe cases. It's also important to note that trends in infectious complications after partial colectomy for colon cancer have shown a decrease in overall infectious complications, but an increase in organ space infection rates specifically 2. Overall, a comprehensive approach to preventing and treating fungal infections is essential to minimize the risk of morbidity and mortality in patients undergoing total colonectomy.