Prophylactic Antibiotics for Elective Laparoscopic Cholecystectomy
| Autor: | William Haun, S Charland, Jeffrey Clark, A Higgins, J London, D P Maher, Erick R. Ratzer |
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| Rok vydání: | 1999 |
| Předmět: |
medicine.medical_specialty
Cefotetan medicine.medical_treatment Cefazolin Placebo Preoperative care Double-Blind Method medicine Humans Prospective Studies Antibiotic prophylaxis Cephamycins Antibacterial agent business.industry Antibiotic Prophylaxis Middle Aged Cephalosporins Surgery Cholecystectomy Laparoscopic Elective Surgical Procedures Anesthesia Cholecystectomy business Elective Surgical Procedure medicine.drug |
| Zdroj: | Archives of Surgery. 134:611 |
| ISSN: | 0004-0010 |
| DOI: | 10.1001/archsurg.134.6.611 |
| Popis: | Hypothesis Prophylactic antibiotic treatment in elective laparoscopic cholecystectomy does not lower the already low infection rate associated with this procedure. Design and Setting Prospective double-blind randomized trial at a community-based training hospital. Patients Four hundred fifty patients undergoing elective laparoscopic cholecystectomy were randomized into 1 of 3 treatment arms: (1) preoperative cefotetan disodium, 1 g intravenously; (2) preoperative cefazolin, 1 g intravenously; and (3) intravenous placebo. There were no demographic differences between groups in age, smoking history, American Society of Anesthesiologists score, infection risk class, time of antibiotic administration prior to surgery, and type of skin preparation. Interventions Laparoscopic cholecystectomy was attempted in all cases; however, 10 patients required conversion to an open cholecystectomy and they were included in the statistical analysis. Preoperatively, all patients were randomized in a blinded manner and received cefotetan, cefazolin, or placebo intravenously. Results There were 10 postoperative infections. In the cefotetan group, there were 3 cases of superficial surgical site infections. In the cefazolin group, there were 2 superficial surgical site infections—1 pneumonia and 1 rhinosinusitis. In the placebo group, there were 2 superficial surgical site infections and 1 urinary tract infection. The overall infection rate in this series was 2.4%. Follow-up was performed at routine postoperative visits and by telephone contact. Data were evaluated using the χ 2 test and analysis of variance with Duncan post hoc test ( P Conclusion Based on our data, use of prophylactic antibiotics does not decrease the rate of wound infections in elective laparoscopic cholecystectomy. |
| Databáze: | OpenAIRE |
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