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ANTIBIOTIC PROPHYLAXIS IN LAPAROSCOPIC CHOLECISTECTOMY: IS IT WORTH DOING?
Márcio Alexandre Terra Passos1, Pedro Eder Portari-Filho2
1University Hospital Severino Sombra, Vassouras, RJ, Brazil.
Insights
Routine antibiotic prophylaxis offers no significant benefit in preventing surgical site infections for low-risk patients undergoing elective laparoscopic cholecystectomy. This study found similar infection rates in both prophylaxis and no-prophylaxis groups.
Area of Science:
- Surgical Infections
- Antibiotic Prophylaxis
- Minimally Invasive Surgery
Background:
- Elective laparoscopic cholecystectomy carries a low risk of infectious complications, with reported rates between 0.4% and 1.1%.
- Despite the low risk, many surgeons routinely administer antibiotic prophylaxis for this procedure.
Purpose of the Study:
- To evaluate the actual impact of antibiotic prophylaxis on preventing infectious complications in low-risk patients undergoing elective laparoscopic cholecystectomy.
Main Methods:
- A prospective, randomized, double-blind study was conducted with 100 patients.
- Patients were divided into two groups: Group A (n=50) received intravenous Cefazolin prophylaxis, and Group B (n=50) received no antibiotic prophylaxis.
- Surgical site infections were assessed at 7 and 30 days post-surgery.
Main Results:
- The incidence of infectious complications was 2% in Group A and 2% in Group B.
- No statistically significant difference in infectious complications was observed between the two groups (p=0.05).
- The study groups were found to be homogeneous and comparable.
Conclusions:
- Antibiotic prophylaxis does not provide a significant benefit in reducing surgical wound infections for patients undergoing elective laparoscopic cholecystectomy with low risk of complications.
Background:
Elective laparoscopic cholecystectomy has very low risk for infectious complications, ranging the infection rate from 0.4% to 1.1%. Many surgeons still use routine antibiotic prophylaxis.
Aim:
Evaluate the real impact of antibiotic prophylaxis in elective laparoscopic cholecystectomies in low risk patients.
Method:
Prospective, randomized and double-blind study. Were evaluated 100 patients that underwent elective laparoscopic cholecystectomy divided in two groups: group A (n=50), patients that received prophylaxis using intravenous Cephazolin (2 g) during anesthetic induction and group B (n=50), patients that didn't receive any antibiotic prophylaxis. The outcome evaluated were infeccious complications at surgical site. The patients were reviewed seven and 30 days after surgery.
Results:
There was incidence of 2% in infection complications in group A and 2% in group B. There was no statistical significant difference of infectious complications (p=0,05) between the groups. The groups were homogeneous and comparable.
Conclusion:
The use of the antibiotic prophylaxis in laparoscopic cholecystectomy in low risk patients doesn't provide any significant benefit in the decrease of surgical wound infection.
