Role of antibiotics on surgical site infection in cases of open and laparoscopic cholecystectomy: A comparative observational study

Gharde, Pankaj; Swarnkar, Manish; Waghmare, Lalitbhushan S; Bhagat, Vijay Manohar; Gode, Dilip; Wagh, Dhirendra; Muntode, Pramita; Rohariya, Hrituraj; Sharma, Anoop

doi:10.4103/2006-8808.135132

“…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 articles 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 were excluded because of the following reasons: inclusion criteria not met, 83 inappropriate intervention, 55 57 70 77 84 inappropriate comparator, 56 58 59 insufficient data reported, 60 61 63 65 66 67 68 69 71 72 73 74 75 76 78 80 81 82 and data duplication. 62 64 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

¹

,

Yu

²

,

Yang

³

et al. 2018

Ann Hepatobiliary Pancreat Surg

View full text Add to dashboard Cite

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.

show abstract

“…The incidence of Port Site Infection (PSI) is variable, ranging mostly from .1 to 10% [7]. Table 1 demonstrated the frequencies of PSI in different studies [8]. Some risk factors were reported in literature to be significant in increasing the incidence of port site infections.…”

Section: Discussionmentioning

confidence: 99%

Role of Antibiotic Prophylaxis in Laparoscopic Cholecystectomy

Elsaady¹

2019

Austin J Surg

0

View full text Add to dashboard Cite

Laparoscopic cholecystectomy is one of the most common abdominal surgical procedures all over the world. It carries a lot of advantages over the open procedure. One of these advantages is the marked decrease in the incidence of surgical site infection. However, no wound is immune and SSI is still present and may be troublesome. The role of antibiotic prophylaxis in preventing or reducing SSI is still a matter of controversy in laparoscopic cholecystectomy. This study is a prospective one that conducted over two years to assess the role of antibiotic prophylaxis and best regimen. Four hundreds and fifty six patients were included which were divided into two large groups; group of simple cholecystectomy and group of risky cholecystectomy .Each group were further subdivided into three groups ; one received no antibiotic at all, the second received single dose of antibiotic, and a third one received antibiotic for at least five days. Sixteen cases developed SSI in the whole study (approximately 3.5%). Group of simple cholecystectomy reported three cases (~1%) suffered from SSI with insignificant value between the three groups. On the other hand in group B (risky group) , thirteen patients developed surgical site infections (~7%) with high statistical significance between the group where patient did not received antibiotics at all and other two groups received antibiotics. Also significant value was found between the group used single dose antibiotic (group 5) and those with at least five days administration of antibiotics, the latter reported less incidence of SSI.The study concluded that; no role of antibiotic prophylaxis in simple cholecystectomy. On the other hand prophylactic antibiotic is strongly recommended in risky cholecystectomy. It is better to give the antibiotic for at least five days in such risky groups. The presence of immune-comprised state, long operation, intraoperative complications, gall bladder injury or spillage of stones make the operation is risky and prone to develop SSI.

show abstract

“…Some risk factors were reported in literature to be significant in increasing the incidence of port site infections. These include; long operation, diabetes, steroid intake and immune compromised state, opening of gall bladder, and spillage of gall bladder stones [8]. Surgical Site Infection (SSI) was defined as infection, which occurs within 30 days of the surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

Role of Antibiotic Prophylaxis in Laparoscopic Cholecystectomy

Elsaady¹

2019

Austin J Surg

0

View full text Add to dashboard Cite

Laparoscopic cholecystectomy is one of the most common abdominal surgical procedures all over the world. It carries a lot of advantages over the open procedure. One of these advantages is the marked decrease in the incidence of surgical site infection. However, no wound is immune and SSI is still present and may be troublesome. The role of antibiotic prophylaxis in preventing or reducing SSI is still a matter of controversy in laparoscopic cholecystectomy. This study is a prospective one that conducted over two years to assess the role of antibiotic prophylaxis and best regimen. Four hundreds and fifty six patients were included which were divided into two large groups; group of simple cholecystectomy and group of risky cholecystectomy .Each group were further subdivided into three groups ; one received no antibiotic at all, the second received single dose of antibiotic, and a third one received antibiotic for at least five days. Sixteen cases developed SSI in the whole study (approximately 3.5%). Group of simple cholecystectomy reported three cases (~1%) suffered from SSI with insignificant value between the three groups. On the other hand in group B (risky group) , thirteen patients developed surgical site infections (~7%) with high statistical significance between the group where patient did not received antibiotics at all and other two groups received antibiotics. Also significant value was found between the group used single dose antibiotic (group 5) and those with at least five days administration of antibiotics, the latter reported less incidence of SSI.The study concluded that; no role of antibiotic prophylaxis in simple cholecystectomy. On the other hand prophylactic antibiotic is strongly recommended in risky cholecystectomy. It is better to give the antibiotic for at least five days in such risky groups. The presence of immune-comprised state, long operation, intraoperative complications, gall bladder injury or spillage of stones make the operation is risky and prone to develop SSI.

show abstract

Role of antibiotics on surgical site infection in cases of open and laparoscopic cholecystectomy: A comparative observational study

Cited by 8 publications

References 23 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

Role of Antibiotic Prophylaxis in Laparoscopic Cholecystectomy

Role of Antibiotic Prophylaxis in Laparoscopic Cholecystectomy

Contact Info

Product

Resources

About