Third-generation cephalosporin for antimicrobial prophylaxis in pancreatoduodenectomy in patients with internal preoperative biliary drainage

Surgery
Shusei SanoKatsuhiko Uesaka

Abstract

The aim of the present study was to investigate whether the incidence of surgical site infection after pancreatoduodenectomy decreased after changing the prophylactic antibiotic to a third-generation cephalosporin in patients with unknown preoperative bile culture results after biliary drainage. In a retrospective study of 138 pancreatoduodenectomy patients who underwent endoscopic biliary stenting and for whom recent preoperative bile culture results were unavailable, cefazolin sodium hydrate was administered as perioperative prophylactic antibiotic therapy from 2010 to 2014 (n = 69); whereas ceftriaxone was administered from 2014 to 2017 (n = 69) based on the results of institutional culture surveillance. The incidence of surgical site infection was compared between the two groups and the risk factor of surgical site infection was also evaluated. The incidence of overall surgical site infection in the ceftriaxone group was significantly lower than that in the cefazolin sodium hydrate group for both Clavien-Dindo grade ≥II (28% versus 52%, P = .005) and Clavien-Dindo grade ≥IIIa (20% vs 41%, P = .016). A multivariate analysis revealed that the prophylactic administration of cefazolin sodium hydrate was associated with a higher...Continue Reading

Citations

Dec 17, 2019·Anesthesiology·Brooke K DeckerNaomi P O'Grady
Dec 15, 2020·Journal of the American College of Surgeons·Masaya SuenagaYasuhiro Kodera
Dec 4, 2020·Surgery·Hannah R ShraderCarlos H F Chan
Dec 15, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Jesse V GroenJ Sven D Mieog

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