Topical antibiotics in cholecystectomy for gallstone diseases

Efficacy of topical antibiotics in cholecystectomy for gallstone disease was evaluated. Forty-four patients who accepted topical single administration of 1 or 2 g each of latamoxef, cefmenoxime, cefotiam or cefamandole during operation were compared with 36 patients with systemic administration of cefem antibiotics by intravenous drip at a dose of 1 or 2 g, twice daily for postoperative 4 to 7 consecutive days. In topical administration group, concentration of each antibiotic in the gallbladder and common duct bile, gallbladder tissue, parietal peritonea and intra- and postoperative peripheral blood exceeded mostly MIC80 against bacteria usually existing in bile by biliary tract infection or bacteria by wound infection. There was no difference between the two groups in postoperative clinical course. Thus, an adequate prophylactic effect can be expected by topical use of antibiotic during cholecystectomy.