Effect of Postoperative Antibiotic Administration on Postoperative Infection Following Cholecystectomy for Acute Calculous Cholecystitis

Régimbeau, Jean Marc; Fuks, David; Pautrat, Karine; Mauvais, F.; Haccart, Vincent; Msika, Simon; Mathonnet, Muriel; Scotté, Michel; Paquet, Jean Christophe; Vons, C.; Sielezneff, I.; Millat, Bertrand; Chiche, Laurence; Dupont, Hervé; Duhaut, P.; Cossé, Cyril; Diouf, Momar; Pocard, Marc

doi:10.1001/jama.2014.7586

Cited by 135 publications

(133 citation statements)

References 26 publications

(26 reference statements)

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“…Full texts of 63 articles were reviewed and assessed for eligibility, and 34 studies including 28 RCTs and 3 prospective and 3 retrospective trials were included in this meta-analysis. Twenty-nine full-text articles555657585960616263646566676869707172737475767778798081828384 were excluded because of the following reasons: inclusion criteria not met,83 inappropriate intervention,5557707784 inappropriate comparator,565859 insufficient data reported, 606163656667686971727374757678808182 and data duplication 6264. The procedure for the study selection is summarized in the PRISMA flow diagram (Fig.…”

Section: Resultsmentioning

confidence: 99%

Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis

Kim

Yang

et al. 2018

Ann Hepatobiliary Pancreat Surg

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Backgrounds/AimsThe role of prophylactic antibiotics for laparoscopic cholecystectomy in low-risk patients is still unclear. This study aimed to verify the conclusion of previous meta-analyses concerning the effectiveness of antibiotic prophylaxis for elective laparoscopic cholecystectomy in low-risk patients.MethodsComprehensive literature searches were performed on electric databases and manual searches. Randomized controlled trials (RCTs), prospective studies, and retrospective studies comparing antibiotic prophylaxis to placebo or no antibiotics in low-risk elective laparoscopic cholecystectomy were included.ResultsThis study included 28 RCTs, three prospective studies, and three retrospective studies. In RCTs, prophylactic antibiotics did not prevent deep surgical site infections (SSI) (RR 1.10, 95% confidence interval [CI] [0.45–2.69], p=0.84) but reduced SSI (RR 0.70, 95% CI [0.53–0.94], p=0.02), and superficial SSI (RR 0.58, 95% CI [0.42–0.82], p=0.01). Prospective studies showed prophylactic antibiotics did not reduce superficial SSI (RR 0.35, 95% CI [0.01–8.40], p=0.52) but reduced SSI (RR 0.12, 95% CI [0.04–0.35], p=0.0001). In retrospective studies, antibiotic prophylaxis did not reduce SSI (RR 1.59, 95% CI [0.30–8.32], p=0.58). The pooled data (12121 patients) including RCTs and prospective and retrospective studies showed that prophylactic antibiotics were not effective in preventing deep SSI (RR 1.01 95% CI [0.46–2.21], p=0.98) but effective in reducing SSI (RR 0.67, 95% CI [0.51–0.88], p=0.003) and superficial SSI (RR 0.61, 95% CI [0.45–0.83], p=0.002).ConclusionsThe use of prophylactic antibiotics is effective for reducing the incidence of SSI and superficial SSI but is not effective for preventing deep SSI in low-risk patients who underwent elective laparoscopic cholecystectomy.

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Section: Resultsmentioning

confidence: 99%

Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis

Kim

Yang

et al. 2018

Ann Hepatobiliary Pancreat Surg

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“…In an observational study of 287 patients with moderate acute cholecystitis, antibiotic treatment for 4 days after early cholecystectomy did not decrease the incidence of surgical site infections when compared to patients who received antibiotics postoperatively for 0 to 4 days [59]. In an RCT of 414 patients, after early laparoscopic cholecystectomy for mild or moderate acute cholecystitis, lack of postoperative antibiotics did not result in a greater incidence of postoperative infections compared to patients who received antibiotics postoperatively for 5 days [28]. Trial evidence and expert opinion suggest there is no benefit in continuing antibiotics beyond 24 h after cholecystectomy for uncomplicated acute cholecystitis.…”

Section: The Use Of Antibiotics In Acute Cholecystitismentioning

confidence: 90%

Surgical management of acute cholecystitis

Koti

Davidson

2015

Langenbecks Arch Surg

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“…Most studies found that post operative antibiotic administration did not reduce the incidence of SSI compared to patients who received placebo on the post operative period [17,18]. A study involving patients undergoing renal transplant showed that a single dose of appropriate antibiotic agent was as good as multiple doses especially in patients with no additional co-morbidities [19].…”

Section: What Is the Optimal Timing Of Antibiotic Prophylaxis In Surgmentioning

confidence: 99%

Timing and Choice of Antibiotic Prophylaxis for Prevention of Surgical Site Infections: A Systemic Review

Okello¹

2017

UCMS

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BACKGROUND: Surgical site infection (SSI) doubles the mortality, cost, hospital stay and the rate of ICU admission in post operative patients. Parenteral antibiotic administration in the perioperative period is one of the effective strategies for prevention of SSI. However, the practice around administration of antibiotics in this setting is often not standardized, depending mainly on surgeon's preference. OBJECTIVE: We set out to clarify the timing of antibiotic for prophylaxis in surgery and the most appropriate antibiotic choice. METHODS: The study was a systematic review of literature on the subject within the last 5 years. Literature was retrieved from "Google Scholar", "Pubmed" and "Medline". Those that met the eligibility criteria were included and analyzed. RESULTS: The reviewed literature indicated that antibiotic prophylaxis should be administered within 60 minutes before surgical incision and should not be continued beyond 24 to 48 hours. The choice should be guided by local susceptibility patterns, but cefazolin or cefuroxime or ampicillin-sulbactam are used in most settings. Metronidazole should be added when anaerobic organisms are expected. CONCLUSIONS AND RECOMMENDATION: We recommend a review of guidelines or institution of guidelines where none exists, to reinforce the timing and choice of antibiotic for pre-operative prophylaxis.

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Effect of Postoperative Antibiotic Administration on Postoperative Infection Following Cholecystectomy for Acute Calculous Cholecystitis

Abstract: clinicaltrials.gov Identifier: NCT01015417.

Cited by 135 publications

References 26 publications

Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis

Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis

Surgical management of acute cholecystitis

Timing and Choice of Antibiotic Prophylaxis for Prevention of Surgical Site Infections: A Systemic Review

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