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Abstract:
Seventy-seven patients who had elective pulmonary resections were enrolled in a prospective double-blind study to assess the role of prophylactic antibiotics in preventing postoperative infections. Criteria for infection were strictly defined. A five-day course of a cephalosporin (2 gm/day in divided doses) was compared to an identical placebo. There were 17 infections in the 34 patients in the placebo group (50%), compared to only eight infections in the 43 patients in the antibiotic group (19%) (P = .005). When infections unrelated to thoracotomy and minor infections were excluded, the advantage of prophylactic antibiotics proved even more evident. Fourteen thoracic infections occurred in the placebo group (41%) compared to only two thoracic infections (4.7%) in the antibiotic group (P = .0002). No relationship of infection rate to the extent of pulmonary resection was found. A history of smoking, the presence or absence of chronic bronchitis, spirometric abnormalities, and obesity were all analyzed; none was related to the development of infection. We conclude that the routine use of perioperative antibiotics is indicated to prevent postoperative infections in pulmonary resection.
Insights
Prophylactic antibiotics significantly reduced postoperative infections in patients undergoing pulmonary resection. Routine use of perioperative antibiotics is recommended to prevent surgical site infections after lung surgery.
Area of Science:
- Thoracic Surgery
- Infectious Disease Prevention
- Clinical Pharmacology
Background:
- Postoperative infections are a significant concern following pulmonary resections.
- Identifying effective strategies to prevent these infections is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of prophylactic antibiotics in preventing postoperative infections after elective pulmonary resections.
- To determine if routine antibiotic use is indicated in this patient population.
Main Methods:
- Prospective, double-blind, placebo-controlled study involving 77 patients undergoing pulmonary resection.
- Comparison of a five-day course of cephalosporin versus an identical placebo.
- Strict criteria were used to define and assess postoperative infections.
Main Results:
- A significantly lower infection rate was observed in the antibiotic group (19%) compared to the placebo group (50%) (P = .005).
- When focusing on thoracic infections, the difference was even more pronounced: 4.7% in the antibiotic group versus 41% in the placebo group (P = .0002).
- No correlation was found between infection rates and factors like smoking history, chronic bronchitis, spirometric abnormalities, or obesity.
Conclusions:
- The routine use of perioperative prophylactic antibiotics is indicated to effectively prevent postoperative infections in patients undergoing pulmonary resection.
- Antibiotic prophylaxis demonstrates a clear benefit in reducing the incidence of surgical site infections after lung surgery.