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Mezlocillin prophylaxis in biliary tract surgery. Results of a retrospective and a prospective trial
Abstract:
We have evaluated the case histories of all patients who underwent surgery of the biliary tract in 1979. In that year every surgeon was able to administer antibiotics postoperatively whenever he considered it necessary. Of the 71 patients, 39% received postoperative antibiotic treatment. In 1980, 50 patients over the age of 50 received a 36-hour course of mezlocillin prophylaxis when they underwent surgery of the biliary tract, either as an elective or emergency operation. Only 8% of these patients required antibiotics postoperatively. In comparison to the 39% from 1979, this difference is highly significant statistically. This pilot study justifies further investigations to determine whether single-dose mezlocillin prophylaxis is able to reduce the incidence of infectious complications, the duration of the hospital stay and the total amount of antibiotics administered.
Insights
Postoperative antibiotic use in biliary tract surgery significantly decreased from 39% to 8% with mezlocillin prophylaxis. This pilot study suggests mezlocillin prophylaxis may reduce complications and antibiotic usage.
Area of Science:
- Surgical Infections
- Antibiotic Prophylaxis
- Biliary Tract Surgery
Background:
- Historically, postoperative antibiotics were administered at surgeon's discretion in biliary tract surgery.
- In 1979, 39% of patients undergoing biliary tract surgery received postoperative antibiotics.
Purpose of the Study:
- To evaluate the impact of mezlocillin prophylaxis on postoperative antibiotic requirements in patients undergoing biliary tract surgery.
- To assess if mezlocillin prophylaxis can reduce infectious complications, hospital stay, and overall antibiotic administration.
Main Methods:
- A retrospective analysis of 71 patients from 1979 (no prophylaxis) and a prospective study of 50 patients from 1980 (mezlocillin prophylaxis).
- Patients in 1980 received a 36-hour course of mezlocillin prophylaxis for biliary tract surgery (elective or emergency).
Main Results:
- Postoperative antibiotic use dropped significantly from 39% in 1979 to 8% in 1980 among patients undergoing biliary tract surgery.
- The reduction in postoperative antibiotic requirements with mezlocillin prophylaxis was statistically significant.
Conclusions:
- A 36-hour course of mezlocillin prophylaxis appears effective in reducing the need for postoperative antibiotics in biliary tract surgery.
- Further research is warranted to confirm the benefits of single-dose mezlocillin prophylaxis on infectious complications and hospital stay.