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Role of antibiotic prophylaxis on surgical site infection prevention in a low-risk population undergoing laparoscopic
Kaleem Ullah1, Abdul Wahab Dogar1, ZakaUllah Jan2
1Pir Abdul Qadir Shah Jillani Institute of Medical Sciences, Gambat, Pakistan.
Insights
Prophylactic antibiotics do not significantly impact surgical site infections (SSIs) in low-risk patients undergoing laparoscopic cholecystectomy. This study suggests routine pre-operative antibiotics may be avoidable in this patient group.
Area of Science:
- Surgical Oncology
- Infectious Disease Prevention
- Gastrointestinal Surgery
Background:
- Surgical site infections (SSIs) are a significant concern in post-operative care.
- Laparoscopic cholecystectomy (LC) is a common procedure with varying SSI rates.
- The role of prophylactic antibiotics in low-risk LC patients requires further investigation.
Purpose of the Study:
- To compare the incidence of SSIs in low-risk patients undergoing LC.
- To evaluate the efficacy of pre-operative antibiotics versus no antibiotics in preventing SSIs.
Main Methods:
- Prospective, open-label, randomized controlled study.
- Two groups: Group A received pre-operative cefazolin; Group B received no antibiotics.
- Patients were monitored for SSIs for 30 days post-surgery.
Main Results:
- SSI incidence was 3.98% in the antibiotic group and 4.9% in the no-antibiotic group (p=0.584).
- No statistically significant difference in SSI rates between the two groups.
- Comparable age, gender distribution, operative duration, and hospital stay between groups.
Conclusions:
- Pre-operative antibiotics did not demonstrate a significant impact on preventing SSIs in low-risk LC patients.
- The incidence of SSIs in this low-risk population is low.
- Prophylactic antibiotics may be avoidable in select low-risk patients undergoing LC.
Objective:
To compare the incidence of surgical site infections (SSIs) in low-risk patients undergoing laparoscopic cholecystectomy (LC) with pre-operative antibiotics versus no pre-operative antibiotics administration.
Study Design:
Randomized controlled study.
Setting:
Hepatobiliary department, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Pakistan, from Jul 1, 2018, to Jun 30, 2021.
Methods:
This is a prospective, open-label, randomized study. Individuals scheduled for laparoscopic cholecystectomy who met the inclusion requirements were randomly assigned to two groups. Group A patients received pre-operative antibiotics (intravenous cefazolin 2-g), and group B patients were operated on without administration of pre-operative antibiotics. Post-operatively, patients were studied for the occurrence of SSIs for 30 days.
Results:
The mean age of patients in group A was 40.6 + 5.2 years, while group B was 41.04 + 5.03. The male to female ratio was 1:3. Gender distribution showed female dominance in both groups, i.e., 78.74% in group A and 76.80% in group B. The incidence of SSI in group A was 3.98%, while in group B was 4.9% (p-value = 0.584). No statistical significance was found while comparing both groups' age, gender, operative duration, and hospital stay.
Conclusion:
This study showed comparable results between both groups, and prophylactic antibiotics have no impact in preventing SSIs. In low-risk individuals undergoing laparoscopic cholecystectomy, the incidence of SSIs is quite low, and prophylactic antibiotics can be avoided.
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