Most infections following gastrointestinal surgery are caused by the escape of endogenous microorganisms at the time of operation. A thorough understanding of the gastrointestinal microflora in health and disease is essential to the intelligent treatment of postoperative septic complications. The oral flora found under certain circumstances in the proximal gastrointestinal tract is usually penicillin sensitive. Both aerobic and anaerobic resident microflora of the distal ileum and colon are penicillin resistant; therefore, other antibiotic agents must be prescribed for successful treatment of sepsis following resection of these organs.
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