Antibiotic prophylaxis in hernia repair and breast surgery: a prospective randomized study comparing piperacillin/tazobactam versus placebo
| Autor: | Silvana Noviello, Bellitti F, V. Cuniato, A. Marvaso, F. Ianniello, Sebastiano Leone, Silvano Esposito |
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| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Breast surgery Penicillanic Acid Breast Neoplasms In Vitro Techniques Placebo law.invention Sex Factors Randomized controlled trial Double-Blind Method law medicine Humans Surgical Wound Infection Pharmacology (medical) Prospective Studies Antibiotic prophylaxis Prospective cohort study Mastectomy Herniorrhaphy Pharmacology Piperacillin Univariate analysis business.industry Age Factors Middle Aged Antibiotic Prophylaxis Hernia repair Surgery Anti-Bacterial Agents Infectious Diseases Piperacillin Tazobactam Drug Combination Oncology Piperacillin/tazobactam Drainage Lymph Node Excision Female business medicine.drug |
| Popis: | Although antibiotic prophylaxis is not explicitly indicated for hernia repair and breast surgery, its use for these clean procedures is widely adopted, albeit to a different extent in different countries, often on the personal decision of the individual surgeon. The present study was carried out to compare the efficacy of a single pre-operative dose of piperacillin-tazobactam with placebo in preventing surgical wound infections and to determine the main risk factors associated with infections following two main elective surgical clean procedures such as hernia repair and breast surgery.A total of 501 patients undergoing elective inguinal/femoral hernia repair or breast surgery were enrolled in this prospective randomized clinical study. Patients were randomly assigned to receive preoperative antibiotic prophylaxis or placebo. One dose of piperacillin-tazobactam 2.250 g or placebo was administered i.v. 30 minutes prior to the surgical procedure. Using statistical univariate analysis, the following variables were correlated with a higher infection risk: age40 years, concomitant disease, WBC3500, surgical wound size9cm, use of drainages, non-prophylaxis. Using multivariate analysis, no antibiotic pre-operative prophylaxis, concurrent chronic diseases, especially diabetes (risk 15 times higher), and length of intervention45 min (risk 6 times higher) were independent predictors of infection. Finally, patients with postoperative infections had a significantly longer hospitalisation. One pre-operative dose of piperacillin-tazobactam 2.250 g is more effective than placebo in preventing postoperative infections in breast surgery and hernia repair. |
| Databáze: | OpenAIRE |
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