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Area of Science:

  • Infectious Disease
  • Surgical Outcomes
  • Pharmacology

Background:

  • Surgical site infections (SSIs) are a significant concern in colorectal surgery.
  • Previous studies suggest β-lactam prophylaxis may reduce SSIs compared to alternatives.
  • Variations in antibiotic dosing and timing have been reported, potentially affecting outcomes.

Purpose of the Study:

  • To compare SSI incidence between β-lactam and non-β-lactam prophylaxis in elective colorectal surgery.
  • To assess the impact of guideline-concordant antibiotic dosing and timing on SSI risk.

Main Methods:

  • Multicenter retrospective cohort study.
  • Included adult patients undergoing elective colorectal surgery from July 2012 to June 2021.
  • Used modified Poisson regression and propensity score matching to analyze SSI risk.

Main Results:

  • β-lactam prophylaxis was associated with a lower risk of SSIs (ARR, 0.74; 95% CI, 0.63-0.87).
  • Patients receiving β-lactam prophylaxis more frequently received guideline-concordant dosing and timing.
  • Neither guideline-concordant dosing nor timing were independently associated with SSI risk in adjusted analyses.

Conclusions:

  • β-lactam surgical prophylaxis is associated with reduced SSI risk in elective colorectal surgery.
  • Observed differences in SSI rates between prophylaxis regimens are not explained by variations in guideline-concordant dosing or timing.
  • Findings support the use of β-lactam prophylaxis for reducing SSIs in this patient population.