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Antibiotic prophylaxis in elective laparoscopic cholecystectomy is useless. A prospective multicenter study
Annali Italiani Di Chirurgia
|December 30, 2014
Summary
Antibiotic prophylaxis (AP) did not reduce surgical site infections (SSIs) in elective laparoscopic cholecystectomy (LC). Focus on umbilical site care is recommended, especially for longer procedures, as AP showed no benefit in preventing these infections.
Area of Science:
- Surgical Infection Prevention
- Laparoscopic Surgery Outcomes
- Antibiotic Prophylaxis Efficacy
Background:
- Superficial surgical site infections (SSIs) are a concern in elective laparoscopic cholecystectomy (LC).
- The role of antibiotic prophylaxis (AP) in preventing SSIs in LC remains under investigation.
Purpose of the Study:
- To prospectively evaluate the impact of antibiotic prophylaxis (AP) on the incidence of SSIs following elective laparoscopic cholecystectomy (LC).
Main Methods:
- A prospective study involving patients undergoing elective LC for benign conditions.
- Patients received either ampicillin-sulbactam, ciprofloxacin, or no antibiotic prophylaxis (AP).
- Infection rates, particularly superficial surgical site infections (SSIs), were monitored postoperatively.
Main Results:
- Overall infection rate was 8.2%, with all infections being superficial surgical site infections (SSIs) at the umbilical incision.
- No significant difference in SSI incidence was observed between the antibiotic prophylaxis (AP) groups and the no-AP group (7.3%, 7.5%, and 9.4%, respectively; p=0.916).
- Multivariate analysis identified duration of operation as the only significant predictor of SSIs.
Conclusions:
- Routine antibiotic prophylaxis (AP) is not recommended for elective laparoscopic cholecystectomy (LC).
- Increased risk of SSIs, particularly at the umbilical site, is associated with longer operative times.
- Enhanced preoperative cleaning and topical antibiotic therapy for the umbilical area may be beneficial.