Comparison of Cefazolin and Ceftriaxone as Antimicrobial Prophylaxis in Pancreatoduodenectomy with Preoperative Drainage: Incidence of Surgical Site Infection and Susceptibility of Bacteria in Bile.
Humans
Cefazolin
/ therapeutic use
Surgical Wound Infection
/ epidemiology
Ceftriaxone
/ therapeutic use
Pancreaticoduodenectomy
/ adverse effects
Bile
/ microbiology
Incidence
Retrospective Studies
Antibiotic Prophylaxis
Anti-Bacterial Agents
/ therapeutic use
Bacteria
Anti-Infective Agents
/ therapeutic use
Drainage
/ adverse effects
Journal
World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
accepted:
07
08
2023
medline:
5
12
2023
pubmed:
25
9
2023
entrez:
24
9
2023
Statut:
ppublish
Résumé
The optimal perioperative antimicrobial agent for preventing surgical site infection (SSI) in pancreatoduodenectomy (PD) with preoperative biliary drainage (PBD) remains unclear. We retrospectively reviewed 288 patients who underwent PD after PBD between 2010 and 2020 at our institution. Patients were classified into two groups according to the perioperative antimicrobial agent used (cefazoline [CEZ] group [n = 108] and ceftriaxone [CTRX] group [n = 180]). The incidence of SSI, type of bacteria in intraoperative bile culture (IBC), and antimicrobial susceptibility to prophylactic antimicrobial agents were analyzed. The incidence of incisional SSI was significantly lower in the CTRX group than in the CEZ group (18% vs. 31%, P = 0.021), whereas the incidence of organ/space SSI in the two groups did not differ to a statistically significant extent (35% vs. 44%, P = 0.133). Gram-negative rod (GNR) bacteria in the IBC showed better antimicrobial susceptibility in the CTRX group than in the CEZ group. In multivariate analysis, antimicrobial resistance due to GNR was a significant risk factor for incisional SSI (odds ratio, 3.50; P < 0.001). CTRX had better antimicrobial coverage than CEZ for GNR cultured from intraoperative bile samples. In addition, CTRX provides better antimicrobial prophylaxis than CEZ against superficial SSI in patients with PD after PBD. This study was not a clinical trial and had no registration numbers.
Sections du résumé
BACKGROUND
BACKGROUND
The optimal perioperative antimicrobial agent for preventing surgical site infection (SSI) in pancreatoduodenectomy (PD) with preoperative biliary drainage (PBD) remains unclear.
METHODS
METHODS
We retrospectively reviewed 288 patients who underwent PD after PBD between 2010 and 2020 at our institution. Patients were classified into two groups according to the perioperative antimicrobial agent used (cefazoline [CEZ] group [n = 108] and ceftriaxone [CTRX] group [n = 180]). The incidence of SSI, type of bacteria in intraoperative bile culture (IBC), and antimicrobial susceptibility to prophylactic antimicrobial agents were analyzed.
RESULTS
RESULTS
The incidence of incisional SSI was significantly lower in the CTRX group than in the CEZ group (18% vs. 31%, P = 0.021), whereas the incidence of organ/space SSI in the two groups did not differ to a statistically significant extent (35% vs. 44%, P = 0.133). Gram-negative rod (GNR) bacteria in the IBC showed better antimicrobial susceptibility in the CTRX group than in the CEZ group. In multivariate analysis, antimicrobial resistance due to GNR was a significant risk factor for incisional SSI (odds ratio, 3.50; P < 0.001).
CONCLUSIONS
CONCLUSIONS
CTRX had better antimicrobial coverage than CEZ for GNR cultured from intraoperative bile samples. In addition, CTRX provides better antimicrobial prophylaxis than CEZ against superficial SSI in patients with PD after PBD.
TRIAL REGISTRATION NUMBER
BACKGROUND
This study was not a clinical trial and had no registration numbers.
Identifiants
pubmed: 37743380
doi: 10.1007/s00268-023-07174-3
pii: 10.1007/s00268-023-07174-3
doi:
Substances chimiques
Cefazolin
IHS69L0Y4T
Ceftriaxone
75J73V1629
Anti-Bacterial Agents
0
Anti-Infective Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3298-3307Informations de copyright
© 2023. The Author(s) under exclusive licence to Société Internationale de Chirurgie.
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