Routine Use of Prophylactic Antibiotics during Laparoscopic Cholecystectomy Does Not Reduce the Risk of Surgical Site Infections
| Autor: | Sadık Kiliçturgay, Ekrem Kaya, Yilmaz Ozen, Pinar Sarkut, Hikmet Aktas |
|---|---|
| Přispěvatelé: | Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı., Sarkut, Pınar, Özen, Yılmaz, Kaya, Ekrem, AAG-7319-2021 |
| Rok vydání: | 2017 |
| Předmět: |
Infection risk
Male Conference Paper Scoring system Cephalosporin Antibiotics Cefazolin Diabetes mellitus 0302 clinical medicine Biliary colic Infection prevention Bile Antiinfective agent Controlled clinical trial Aged 80 and over Double blind procedure Cholecystectomy Laparoscopic Operation duration Randomized controlled trial 030220 oncology & carcinogenesis Cefuroxime axetil Medical history 030211 gastroenterology & hepatology Surgical site infection Human Microbiology (medical) medicine.medical_specialty Efficacy Gallbladder perforation Gram negative bacterium Major clinical study Placebo Microbiology 03 medical and health sciences Laparoscopic Humans Surgical Wound Infection Prophylactic antibiotics Cholecystectomy Aged Bacterial growth Pregnancy Bacteria Prophylaxis Prevention Gold standard Very elderly Surgical infection medicine.disease Postoperative complication Length of stay Pancreatitis Surgery Risk factor Rare disease Enterococcus faecium Need Bacterium Postoperative infection Cholelithiasis Enterococcus faecalis Antibiotic prophylaxis Priority journal Risk assessment Antibiotic agent Smoking Preoperative period Middle Aged Anti-Bacterial Agents Tissue culture Infectious Diseases Female Surgical drainage medicine.drug Adult Bacterium isolate Antibiotic Prophylaxis Surgical Infection Adolescent medicine.drug_class Laparoscopic cholecystectomy Young Adult Double-Blind Method Escherichia coli Staphylococcus epidermidis medicine Obesity Human tissue Elective surgery business.industry Chronic cholecystitis Staphylococcus haemolyticus Acute cholecystitis Drug efficacy Isolation and purification Statistics and numerical data Risk reduction business Controlled study |
| Zdroj: | Surgical Infections. 18:603-609 |
| ISSN: | 1557-8674 1096-2964 |
| DOI: | 10.1089/sur.2016.265 |
| Popis: | Bu çalışma, 22-24 Kasım 2012 tarihleri arasında İstanbul[Türkiye]’da düzenlenen 16. Annual Meeting of the European-Society-of-Surgery (ESS)’da bildiri olarak sunulmuştur. Background: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallbladder stones. As infections are rare in uncomplicated LC, it is widely accepted that prophylactic antibiotics need not be administered, and guidelines do not support routine antibiotic prophylaxis during elective LC. However, routine antibiotic prophylaxis for elective LC is still popular in many clinical settings. We investigated this situation in our department. Method: This randomized double-blind controlled study included 570 patients who underwent LC between March 2007 and February 2010. The exclusion criteria were antibiotic intake before surgery, steroid treatment, and the presence of pancreatitis, cholangitis, obstructive jaundice, cephalosporin allergy, or pregnancy. The patients were randomized into three groups. Group 1 (n = 193) received physiologic saline as placebo, Group 2 (n = 191) received a first-generation cephalosporin (cefazolin; 1 g), and Group 3 (n = 186) received a second-generation cephalosporin (cefuroksim aksetil; 750mg). Bile and epigastric and umbilical port tissue samples were harvested for culture. All patients were observed until the end of the fourth week after surgery. Patient age, sex, weight, American Society of Anesthesiologists (ASA) score, diabetes mellitus, smoking history, history of biliary colic in the past month, length of the hospital stay before the operation, operational findings (acute or chronic cholecystitis), operation duration, use of drainage, type of prophylaxis administered if any, culture results, surgical site infection (SSI) development, and time to SSI development along with associated treatments were evaluated. Results: There was no statistically significant difference between the groups with respect to any of the demographic and clinical features analyzed in this study. The SSI rate was 1.2% in total, and in Groups 1, 2, and 3, it was 1.5%, 1.04%, and 1.07%, respectively. There was no statistical difference regarding SSI among the groups (p = 1.00). Superficial SSI was observed in all groups, and in all patients, the site of infection was the entrance to the epigastric port through which the gallbladder had been removed. Conclusions: Surgical site infection is rare after LC, and antibiotic prophylaxis does not appear to affect the outcome significantly. Moreover, factors such as positive bile cultures, history of biliary attack, ASA score, diabetes, obesity, and smoking do not have any effect on SSI development. Thus, we conclude that antibiotic prophylaxis is not needed for elective LC. European Soc Surgery |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|