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Systemic prophylactic antibiotics in elective biliary surgery.

Z Kaufman, M Engelberg, A Eliashiv

    Archives of Surgery (Chicago, Ill. : 1960)
    |September 1, 1984
    PubMed
    Summary
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    Prophylactic antibiotics significantly reduced wound infections in elective cholecystectomy patients. This benefit was most pronounced in high-risk individuals, including those with diabetes or positive bile cultures.

    Area of Science:

    • Surgical Infection Prevention
    • Clinical Trials in Surgery
    • Antibiotic Prophylaxis Efficacy

    Background:

    • Surgical site infections (SSIs) are a common complication following cholecystectomy.
    • Identifying effective strategies to minimize SSIs is crucial for patient outcomes.
    • The role of prophylactic antibiotics in elective cholecystectomy requires further clinical validation.

    Purpose of the Study:

    • To evaluate the effectiveness of prophylactic antibiotics in reducing wound infections after elective cholecystectomy.
    • To identify patient-specific factors that may influence the efficacy of antibiotic prophylaxis.

    Main Methods:

    • A single-blind, controlled randomized trial was conducted with 105 patients undergoing elective cholecystectomy.
    • Patients were allocated to either a prophylactic antibiotic group (n=56) or a control group (n=49).

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  • Wound infection rates were compared between the groups, with subgroup analysis for risk factors.

    • Main Results:

    • The incidence of wound infections was significantly lower in the prophylactic antibiotic group (3.6%) compared to the control group (24.5%).
    • High-risk patients (positive bile cultures, diabetes, appendectomy, choledochotomy) receiving antibiotics had a 24.4% infection rate versus 3.4% in low-risk controls.
    • Prophylactic antibiotics demonstrated a marked reduction in infection rates across various patient subgroups.

    Conclusions:

    • Prophylactic antibiotic administration is effective in reducing wound infections following elective cholecystectomy.
    • Antibiotic prophylaxis is particularly beneficial for high-risk patients, including those with diabetes mellitus, positive bile cultures, or undergoing concomitant procedures like appendectomy or choledochotomy.