Review of Perioperative Prophylactic Antibiotic Use during Laparoscopic Cholecystectomy and Subsequent Surgical Site Infection Development at a Single Children's Hospital

2021 ◽  
Author(s):  
Kayla B. Briggs ◽  
James A. Fraser ◽  
Wendy Jo Svetanoff ◽  
Jessica K. Staszak ◽  
Charles L. Snyder ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Laparoscopic Cholecystectomy ◽  
Surgical Site Infection ◽  
Clinical Signs ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Site Infection ◽  
Intravenous Antibiotics ◽  
Elective Laparoscopic Cholecystectomy ◽  
Preoperative Work Up

Abstract Objectives With the rise of antibiotic resistance, the use of prophylactic preoperative antibiotics (PPA) has been questioned in cases with low rates of surgical site infection (SSI). We report PPA usage and SSI rates after elective laparoscopic cholecystectomy at our institution. Materials and Methods A retrospective review of children younger than 18 years who underwent elective outpatient laparoscopic cholecystectomy between July 2010 and August 2020 was performed. Demographic, preoperative work-up, antibiotic use, intraoperative characteristics, and SSI data were collected via chart review. SSI was defined as clinical signs of infection that required antibiotics within 30 days of surgery. Results A total of 502 patients met the inclusion criteria; 50% were preoperatively diagnosed with symptomatic cholelithiasis, 47% with biliary dyskinesia, 2% with hyperkinetic gallbladder, and 1% with gallbladder polyp(s). The majority were female (78%) and Caucasian (80%). In total, 60% (n = 301) of patients received PPA, while 40% (n = 201) did not; 1.3% (n = 4) of those who received PPA developed SSI, compared with 5.5% (n = 11) of those who did not receive PPA (p = 0.01). Though PPA use was associated with a 77% reduction in the risk of SSI in multivariate analysis (p = 0.01), all SSIs were superficial. One child required readmission for intravenous antibiotics, while the remainder were treated with outpatient antibiotics. Gender, age, body mass index, ethnicity, and preoperative diagnosis did not influence the likelihood of receiving PPA. Conclusion Given the relatively low morbidity of the superficial SSI, conservative use of PPA is advised to avoid contributing to antibiotic resistance.

scholarly journals Efficacy of Single Dose versus Multiple Dose of Pre-Operative Antibiotic: Teaching Hospital Based Study

2020 ◽  
Vol 3 (2) ◽  
pp. 25-29
Author(s):  
Kamta Prasad Gupta ◽  
Dinesh Pratap Singh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Single Dose ◽  
Surgical Site Infection ◽  
Prophylactic Antibiotic ◽  
Invasive Procedure ◽  
Anesthesia Induction ◽  
Site Infection ◽  
Time Period ◽  
Study Results ◽  
Elective Laparoscopic Cholecystectomy

Background: The major crisis in any type of surgery is understood to be Surgical Site Infection (SSI). Although laparoscopic cholecystectomy is a nominally invasive procedure, there is a dominant prevalence of SSI in patients. It is also believed that prophylactic antibiotic has major impact in reducing SSI. Subjects & Methods: Seventy cases were enrolled in this study with knowledgeable consent. The study was carried out over a time period of ten months. The subjects acknowledge for elective laparoscopic cholecystectomy were incorporated in our study. Results: Out of the 70 randomized patients, 35 were allotted in single dose (SD group) while 35 patients were allotted in multiple doses (MD group), who got planned treatments and were then investigated. Of the 70 patients, female patients were 58(82.9%) and males were 12(17.1%). Total 43.62 12.18 years was the mean age of patients having symptomatic cholelithiasis, with 18 years as minimum and 77 years as maximum age. The peak of disease was documented in the age group of 30 to 39 years (28.6%). Conclusion: Utility of single antibiotic dose before anesthesia induction in laparoscopic cholecystectomy was likewise efficient as the use of multiple antibiotics doses in surgical site infection of postoperative periods.

scholarly journals Prophylactic Antibiotics in Elective Laparoscopic Cholecystectomy is it Necessary?

2018 ◽  
Vol 16 (2) ◽  
pp. 16-18
Author(s):  
Anup Sharma ◽  
Arun Shah
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Single Dose ◽  
Surgical Site Infection ◽  
Prophylactic Antibiotic ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Medical College ◽  
Group A ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group B

Background: Elective laparoscopic cholecystectomy (LC) has a low risk for Surgical Site Infection (SSI). In spite many surgeons still use prophylactic antibiotics. The aim of this study was to find out the need of prophylactic antibiotics in elective LC. Method: This study was carried out from 2017 June to 2018 August in the Department of Surgery Nepalgunj Medical College and Teaching Hospital Kohalpur (NGMC). Patients were placed into two groups. Group A received a single dose of prophylactic antibiotic and group B patients did not receive any prophylactic antibiotic. In both groups the SSI were recorded and compared. Results: Overall SSI was 5(3.33%) among 150. In group A 2 (2.66%) patients had SSI and in group B 3 (4%) had SSI. Using or not using prophylactic antibiotics did not correlate with SSI (p= .154). Conclusions: Prophylactic antibiotic is not recommended in elective LC. Prophylactic antibiotic does not reduce the rate of SSI.

scholarly journals Survey of Surgeons Regarding Prophylactic Antibiotic Use in Inguinal Hernia Repair

2018 ◽  
Vol 107 (3) ◽  
pp. 208-211 ◽  
Author(s):  
A. P. MacCormick ◽  
J. A. Akoh
Keyword(s):  
Surgical Site Infection ◽  
Perceived Risk ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Hernia Surgery ◽  
Trust Network ◽  
Surgical Trainees ◽  
Infected Mesh

Purpose: The use of prophylactic antibiotics in the mesh repair of inguinal hernias remains controversial. The aim of this study was to determine the perception of surgeons about surgical site infection and how this affects their clinical practice. Methods: A SurveyMonkey of general surgeons and senior surgical trainees was conducted via the local trust network and the questionnaire was displayed on the website of the Association of Surgeons of Great Britain and Ireland and Association of Surgeons in Training. Results: Eighty-one responses were received from surgeons who perform an average of 75 hernia repairs per year – the majority by open technique. Thirty-six (44.4%) used routine antibiotic prophylaxis, 40 (49.4%) selectively, and five (6.2%) not at all as the five surgeons who did not use antibiotics perceived their surgical site infection rate to be <1% and have never removed an infected mesh from a hernia wound. There was no clear difference between those who use prophylactic antibiotics routinely or selectively as the experience of mesh explantation is similar (56% versus 55% had 2–10 meshes removed respectively). Seventy-seven (95%) of surgeons felt a new specific set of guidelines was required. Conclusion: This study highlights the fact that in the absence of clear guidelines, most surgeons base their use of prophylactic antibiotics on their perceived risk or experience of surgical site infection. There is a strong need for a new set of guidelines to address the use of prophylactic antibiotics in groin hernia surgery.

scholarly journals Incidence of post operative surgical site infection in thyroid surgery following single dose of prophylactic antibiotic

2020 ◽  
Vol 22 (1) ◽  
pp. 15-20
Author(s):  
Md Abul Hossan ◽  
Md Ariful Islam ◽  
Tapas Chakraborty ◽  
Firoz Ahmed Khan ◽  
Md Mozharul Islam
Keyword(s):  
Antibiotic Therapy ◽  
Surgical Site Infection ◽  
Thyroid Surgery ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Empirical Antibiotic Therapy ◽  
Site Infection ◽  
Cross Sectional

Surgical site infection after thyroid surgery is a less common incidence. Prophylactic antibiotic before surgery and empirical antibiotic therapy after surgery is a common practice in our country. But international guidelines do not suggest antibiotic in clean surgical procedure. Aim: To compare the incidence of surgical site infection after thyroid surgery with and without empirical antibiotic therapy. Method: It was a cross sectional study, done from July 2010 to December 2010 in 3 medical college hospitals in Dhaka city. Total 100 cases were included in this study, 50 cases for study in which only single prophylactic antibiotic used half an hour before operation, 50 cases for control in which 7 days antibiotic used per orally in addition to prophylaxis. Result: Among 100 cases male were 24 & female 76 (M: F= 1:3.2). Oldest patient was 56 yrs & youngest 21yrs. 47% patient operated for solitary thyroid nodule, 35% multinodular goiter & only 6% diffuse goiter. 47% patient was done hemithyroidectomy & only 7% total thyroidectomy. All the operations were completed within 2 hours where 40% within one hour. No surgical site infections were found in both study and control cases. Conclusion: There is no statistical difference between routine antibiotic use and no use of antibiotic after thyroid surgery. Bangladesh J Otorhinolaryngol; April 2016; 22(1): 15-20

scholarly journals Why are we still using antibiotic prophylaxis in elective laparoscopic cholecystectomy for the low-risk groups? a review of literature

2021 ◽  
Vol 8 (2) ◽  
pp. 760
Author(s):  
Devajit Chowlek Shyam ◽  
Ranjit Chowlek Shyam ◽  
Donkupar Khongwar ◽  
Dathiadiam Tongper
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Open Cholecystectomy ◽  
Gallstone Disease ◽  
Port Site ◽  
Low Risk ◽  
Site Infection ◽  
Skin Preparation ◽  
Elective Laparoscopic Cholecystectomy

Gallstone disease is one of the most common gastrointestinal conditions requiring surgery and more than 90% of cholecystectomies are done laparoscopically. The major complications of laparoscopic cholecystectomy are major bleeding, Bile duct injury, and wound infection or surgical site infection. The incidence of Surgical site infection in laparoscopic cholecystectomy (0.4-1.13%) is significantly low compared to open cholecystectomy (3-47%) and the probable reasons are the smaller incision and the use of trocar along with almost nil to minimal wound contamination as compared to open cholecystectomy. Port site infection is a type of surgical site infection (1.8%) and the Umbilical port site is the most common site followed by the epigastric port site. In spite of the low-risk of surgical site infection, many surgeons still practice antibiotic prophylaxis in elective laparoscopic cholecystectomy for low-risk patients. Antibiotic prophylaxis is a debatable topic in the low-risk group undergoing elective laparoscopic cholecystectomy.Meticulous preoperative skin preparation is one of the established local factors to prevent the occurrence of SSI.

scholarly journals Pattern of Perioperative Antibiotic Use in Otorhinolaryngology-Head and Neck Surgery at Third Referral Hospital In Surabaya

2020 ◽  
Vol 3 (1) ◽  
pp. 5
Author(s):  
Nabilah Puspa Utami ◽  
Dyah Fauziah ◽  
Muhtarum Yusuf
Keyword(s):  
Surgical Site Infection ◽  
Operative Procedure ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Neck Surgery ◽  
The Body ◽  
Referral Hospital ◽  
Site Infection ◽  
Cross Sectional ◽  
Perioperative Antibiotics

Introduction: Surgical site infection (SSI) often occurs in operation. SSI frequently only affects the superficial tissues, but some more serious infections can affect the deeper tissues or other parts of the body. The majority of SSIs become apparent within 30 days of an operative procedure, when a prosthetic implant is used, SSI may occur several months after the operation. To minimize surgical site infection occurrence, prophylaxis antibiotic is often used. The aim of the study is to evaluate the use of perioperative antibiotics for otorhinolaryngology surgery in third referral hospital in Surabaya.Methods: This study was a retrospective cross-sectional method through the medical record of patients cases from December 2017 to January 2018. All data about sex, age, diagnosis, wound classification, surgical intervention including ICD 9 CM codes, and antibiotics regiments are presented descriptively.Results: Of total 68 patients, 42 (61.8%) were male and 46 (61.8%) were aged 18-65 years old. The most common type of operation was clean surgery 52 (76.5%). The most common prophylactic antibiotic was cefazoline 25 (96.6%). Conclusion: Most of the performed surgery was clean surgery. The use of perioperative antibiotics in most performed operations was in accordance with existing literature. The most widely used prophylactic and therapeutic antibiotic was cefazoline and ceftriaxone, respectively. Further research about risk factor of SSI, the use of prophylaxis antibiotic, and bacterial profile with more samples is needed for more accurate results.

Sign in / Sign up

Export Citation Format

Share Document