Comparing cefazolin/ metronidazole,  piperacillin-tazobactam, or c efoxitin as surgical antibiotic prophylaxis in patients undergoing pancreaticoduodenectomy: A retrospective cohort study.

Autor: Park LJ; Department of Surgery, Division of General Surgery, McMaster University, Hamilton, Ontario, Canada.; Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada., D'Souza D; Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada., Kazi T; Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada., Rodriguez F; NYU Langone Health, New York University, New York, New York, USA., Griffiths C; Department of Surgery, Division of General Surgery, McMaster University, Hamilton, Ontario, Canada., McKechnie T; Department of Surgery, Division of General Surgery, McMaster University, Hamilton, Ontario, Canada.; Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada., Mertz D; Department of Medicine, Division of Infectious Diseases, McMaster University, Hamilton, Ontario, Canada., Serrano PE; Department of Surgery, Division of General Surgery, McMaster University, Hamilton, Ontario, Canada.; Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2024 Jun; Vol. 129 (8), pp. 1413-1419. Date of Electronic Publication: 2024 Apr 25.
DOI: 10.1002/jso.27641
Abstrakt: Background: Preoperative antibiotic options for pancreaticoduodenectomy (PD) include cefoxitin (CX), piperacillin-tazobactam (PT), or combined cefazolin and metronidazole (CM). Recent studies suggest the superiority of PT over CX, but evidence for CM is unclear.
Objective: To explore the impact of preoperative antibiotic selection (CM vs. PT and CX vs. PT) on the development of surgical site infections (SSI).
Methods: Consecutive adult patients at one institution who underwent PD from November 2017 to December 2021 and received either CM, PT, or CX preoperatively, were included. The primary outcome was SSI. Secondary outcomes included postoperative infections and clinically significant postoperative pancreatic fistula (POPF). Logistic regression models were used.
Results: Among 127 patients included in the study, PT, CM, and CX were administered in 46 (36.2%), 44 (34.6%), and 37 (29.4%) patients, respectively. There were 32 (27.1%) SSI, 20 (36.1%) infections, and 21 (22.9%) POPF events. PT use was associated with reduced risk of SSI compared to CX (OR: 0.32, 95% CI: 0.11-0.89, p = 0.03), but there was no difference as compared to CM (OR: 0.75, 95% CI: 0.27-2.13, p = 0.59). There were no differences in secondary outcomes.
Conclusion: PT reduced SSI rates compared to CX but was no different to CM among patients undergoing PD at our center.
(© 2024 The Authors. Journal of Surgical Oncology published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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