Clinical surgery—international
The impact of prophylactic antibiotics on postoperative infection complication in elective laparoscopic cholecystectomy: a prospective randomized study

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Abstract

Background

The aim of this prospective randomized study was to investigate the necessity and impact of prophylactic antibiotics on postoperative infection complications in elective laparoscopic cholecystectomy.

Methods

At the time of induction of anesthesia, group A patients (n = 141) received 1 g cefazolin, and group B patients (control; n = 136) received 10 mL isotonic sodium chloride solution. Patients’ characteristics and general operative outcomes were compared and analyzed.

Results

The overall rate of infection was 1.1% for total 277 patients (0.7% for group A patients and 1.5 % for group B patients). No significant difference in infection complications was found between these 2 groups. Also any risk factors contributing to infection complications could not be found.

Conclusions

We do not recommend the use of prophylactic antibiotics in elective laparoscopic cholecystectomy because they will not decrease the already-low rate of postoperative infectious complications.

Section snippets

Patient characteristics

From August 2000 to September 2002, 277 patients suffering from symptomatic gallbladder stones or polyps disease with or without acute cholecystitis who were candidates for elective LC were enrolled in this study consecutively. Patients were divided into 2 groups (A and B) by random numbers of operative schedule. At the time of induction of anesthesia, group A patients (n = 141) received 1 g cefazolin, and group B (control) patients (n = 136) received 10 mL isotonic sodium chloride solution. No

Patient’s characteristics and perioperative data

Fifty male and 91 female patients (mean age 50.3 years) were enrolled in group A, and 55 male and 81 female patients (mean age, 52.9 years) were enrolled in group B. Between group A and B patients, there was no difference in characteristics of patients and surgical outcomes (Table 1).

Postoperative infection complications

Overall rate of SSI was 1.1% for 277 patients. No difference in infection complications was found in either group. The use, or not, of prophylactic antibiotics did not correlate with SSIs (P = .148, Table 1). In

Comments

Our data showed that the overall rate of SSIs after LC was just 1.1% (3 of 277 patients), and it was not related to the use of a single dose of cefazolin (1 g). Only 1 patient in group A had space SSI, and two patients in group B had superficial SSIs (wound infections); all three complications were minor (Table 1). The incidences of SSIs in patients were 0.7% and 1.5% for those receiving prophylactic antibiotics or not, respectively (not statically significant). This was comparable with an SSI

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