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 Single dose Intraoperative Antibiotics versus Postoperative Antibiotics for Patient Undergoing Laparoscopic Cholecystectomy for Symptomatic Cholelithiasis

2017 ◽  
pp. 5
Author(s):  
Sagun Bahadur Thapa ◽  
Yashwant Ramakrishan Kher ◽  
Yashwant Gajanan Tambay
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Single Dose ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Prophylactic Antibiotic ◽  
College Teaching ◽  
Intravenous Dose ◽  
Site Infection ◽  
Symptomatic Cholelithiasis ◽  
The Difference

  Introduction: Surgical site infection is a common complication shown in literature following cholecystectomies. Smaller incision and use of trocars in laparoscopic cholecystectomy lessen the contamination resulting in less chances of surgical site infection. However, in fear of postoperative infection, many opt for the prolonged postoperative use of antibiotic and there is growing consensus against it. Antibiotics not only increases the cost and hospital stay duration but it aids in emergence of multidrug resistance. Because of the controversies, we conducted this clinical trial to see whether a single prophylactic dose of antibiotic at the time of induction of anesthesia for laparoscopic cholecystectomy was equally effective in controlling post-operative infection as multi-dose antibiotics during and post-operative period.   Methods: The study was conducted at the department of general surgery, Lumbini Medical College Teaching Hospital, from November  2015 to October 2016. All cases with symptomatic cholelithiasis subjected for laparoscopic cholecystectomy were enrolled. Patients were randomized into two groups; Group SD received single dose of an intravenous dose of amikacin 500 mg, at induction of anesthesia and Group MD received multiple intravenous dose of amikacin, during and postoperatively for two days. Complications, hospital stay, and treatment cost in two groups were compared and analyzed.   Results: There were a total of 240 patients in the study, 118 in Group SD and 122 in Group MD. Post-operative infection rate was 4.2% (n= 5, N=118) in Group SD and 3.3% (n=4, N=122) in Group MD; the difference was not significant (p=0.75). Hospital stay was prolonged and cost was higher significantly in Group MD.   Conclusion: Single dose of prophylactic antibiotic, administered at induction of anesthesia, is equally effective as multiple doses of post surgical antibiotics to prevent post-operative infection in patients undergoing elective laparoscopic cholecystectomy for uncomplicated cholelithiasis.

scholarly journals Single dose Intraoperative Antibiotics versus Postoperative Antibiotics for Patient Undergoing Laparoscopic Cholecystectomy for Symptomatic Cholelithiasis

2017 ◽  
Vol 5 (1) ◽  
pp. 13
Author(s):  
Sagun Bahadur Thapa ◽  
Yeshwant Ramakrishna Kher ◽  
Yashwant Gajanan Tambay
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Single Dose ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Prophylactic Antibiotic ◽  
College Teaching ◽  
Intravenous Dose ◽  
Site Infection ◽  
Symptomatic Cholelithiasis ◽  
The Difference

Introduction: Surgical site infection is a common complication shown in literature following cholecystectomies. Smaller incision and use of trocars in laparoscopic cholecystectomy lessen the contamination resulting in less chances of surgical site infection. However, in fear of postoperative infection, many opt for the prolonged postoperative use of antibiotic and there is growing consensus against it. Antibiotics not only increases the cost and hospital stay duration but it aids in emergence of multidrug resistance. Because of the controversies, we conducted this clinical trial to see whether a single prophylactic dose of antibiotic at the time of induction of anesthesia for laparoscopic cholecystectomy was equally effective in controlling post-operative infection as multi-dose antibiotics during and post-operative period. Methods: The study was conducted at the department of general surgery, Lumbini Medical College Teaching Hospital, from November  2015 to October 2016. All cases with symptomatic cholelithiasis subjected for laparoscopic cholecystectomy were enrolled. Patients were randomized into two groups; Group SD received single dose of an intravenous dose of amikacin 500 mg, at induction of anesthesia and Group MD received multiple intravenous dose of amikacin, during and postoperatively for two days. Complications, hospital stay, and treatment cost in two groups were compared and analyzed. Results: There were a total of 240 patients in the study, 118 in Group SD and 122 in Group MD. Post-operative infection rate was 4.2% (n= 5, N=118) in Group SD and 3.3% (n=4, N=122) in Group MD; the difference was not significant (p=0.75). Hospital stay was prolonged and cost was higher significantly in Group MD. Conclusion: Single dose of prophylactic antibiotic, administered at induction of anesthesia, is equally effective as multiple doses of post surgical antibiotics to prevent post-operative infection in patients undergoing elective laparoscopic cholecystectomy for uncomplicated cholelithiasis.

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.

Abstract P1-20-09: Does a single-dose of pre-operative prophylactic antibiotic reduce surgical site infection following wire-localized lumpectomy?

2020 ◽  
Author(s):  
Gabrielle Bergeron Giguère ◽  
Brigitte Poirier ◽  
Louise Provencher ◽  
Dominique Boudreau ◽  
Dominique Leblanc ◽  
...  
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
Prophylactic Antibiotic ◽  
Site Infection

scholarly journals ANTIBIOTIC PROPHYLAXIS IN BARIATRIC SURGERY: a continuous infusion of cefazolin versus ampicillin/sulbactam and ertapenem

2015 ◽  
Vol 52 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Álvaro Antônio Bandeira FERRAZ ◽  
Luciana Teixeira de SIQUEIRA ◽  
Josemberg Marins CAMPOS ◽  
Guido Correa de ARAÚJO JUNIOR ◽  
Euclides Dias MARTINS FILHO ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Continuous Infusion ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Anesthesia Induction ◽  
Site Infection ◽  
Cross Sectional ◽  
Group I ◽  
Bariatric Patients

Background The incidence of surgical site infection in bariatric patients is significant and the current recommendations for antibiotic prophylaxis are sometimes inadequate. Objective The aim of this study was to analyze the effect of three prophylactic antibiotic regimens on the incidence of surgical site infection. Methods A prospective, cross-sectional study was conducted between January 2009 and January 2013 in which 896 Roux-en-Y gastric bypasses were performed to treat obesity. The study compared three groups of patients according to the perioperative antibiotic prophylaxis administered intravenously and beginning at anesthesia induction: Group I consisting of 194 patients treated with two 3-g doses of ampicillin/sulbactam; Group II with 303 patients treated with a single 1-g dose of ertapenem; and Group III with 399 patients treated with a 2-g dose of cefazolin at anesthesia induction followed by a continuous infusion of cefazolin 1g throughout the surgical procedure. The rate of surgical site infection was analyzed, as well as its association with age, sex, preoperative weight, body mass index and comorbidities. Results The rates of surgical site infection were 4.16% in the group treated prophylactically with ampicillin/sulbactam, 1.98% in the ertapenem group and 1.55% in the continuous cefazolin group. Conclusion The prophylactic use of continuous cefazolin in surgeries for morbid obesity shows very promising results. These findings suggest that some prophylactic regimens need to be reconsidered and even substituted by more effective therapies for the prevention of surgical site infections in bariatric patients.

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 Comparative study on prophylactic antibiotic versus empirical antibiotic in prevention of surgical site infection

2019 ◽  
Vol 9 (2) ◽  
pp. 9-13
Author(s):  
S Rajarajan ◽  
T.H. Sreelekshmi Devi ◽  
Neeshma Mariam Simon ◽  
K.R. Navin Shankar ◽  
V. Ganesan
Keyword(s):  
Single Dose ◽  
Comparative Study ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Prophylactic Antibiotic ◽  
Operative Therapy ◽  
Prophylactic Antibiotics ◽  
Control Group ◽  
P Value ◽  
Site Infection

The main aim of the study was to comparative study of single dose prophylactic antibiotic versus empirical postoperative antibiotics in prevention of surgical site infection. The study was a prospective observational study conducted over a period of 8months. A total of 100 number of surgery cases were selected randomly, to groups of 50 each. The study group received a single dose of antibiotic preoperatively while the control group received 3 to 5 days of empirical antibiotic therapy. Data analysis and statistical analysis was done with the help of graph pad prism trial version software. Student t test was carried out for paired analysis to find P value. There was no significant association of surgical site infection, grades of infection, and other complications. The hospital stay of patients, cost to the patients, and number of antibiotics used in patients were significantly more. The single dose prophylactic antibiotics are better than empirical post operative therapy in reducing the hospital stay and hospital cost to patients. Since the complete eradication of surgical site infection is not possible, only the reduction in infection rate can be achieved to a minimal level. Keywords: Prophylactic antibiotics, surgical site infection, surgical complications, post operative antibiotics.

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