Conclusions The 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
Background s/ Aims The role of prophylactic antibiotics for laparoscopic cholecystectomy in low-risk patients is still unclear .
This study aim ed to verify the conclusion of previous meta-analyses concerning the effectiveness of antibiotic prophylaxis for elective laparoscopic cholecystectomy in low-risk patients .
The value of chemoprophylaxis against Enterococcus species in elective cholecystectomy: a randomized study of cefuroxime vs ampicillin-sulbactam.
HYPOTHESIS Cephalosporins are widely used and considered to be effective as prophylaxis in biliary surgery . Nevertheless , they lack activity against enterococci . We conducted a study to compare the efficacy of ampicillin-sulbactam vs cefuroxime in preventing surgical site infections following elective cholecystectomy . DESIGN A prospect i ve r and omized controlled trial . SETTING A major tertiary care hospital . PATIENTS Four hundred eighteen r and omized patients ( of 549 total ) , who from July 2002 to August 2004 underwent elective open or laparoscopic cholecystectomy with prospect i ve assessment for development of surgical site infections for 1 month postoperatively . INTERVENTION A single intravenous dose of 1.5 g of cefuroxime ( group A , n = 207 ) or 3 g of ampicillin-sulbactam ( group B , n = 211 ) was administered during induction of anesthesia . Bile and gallbladder mucosal cultures were taken intraoperatively from all patients . MAIN OUTCOME MEASURE Number of postoperative surgical site infections . RESULTS A postoperative surgical site infection was noted in 19 ( 4.5 % ) of 418 patients , 18 from group A and 1 from group B ( P<.001 ) . In the group that received cefuroxime , 15 ( 83.3 % ) of 18 surgical site infections were due to Enterococcus species . Intraoperative bactibilia as well as intraoperative gallbladder rupture were associated with surgical site infections ( P<.001 ) . CONCLUSIONS A single dose of ampicillin-sulbactam favored better compared with cefuroxime for prevention of postoperative surgical site infections due to Enterococcus species after elective cholecystectomy . Ampicillin-sulbactam may be a better agent for antimicrobial prophylaxis in high-risk patients undergoing elective cholecystectomy , especially in a setting where the incidence of enterococcal infections is higher
Conclusions The 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
Background s/ Aims The role of prophylactic antibiotics for laparoscopic cholecystectomy in low-risk patients is still unclear .
This study aim ed to verify the conclusion of previous meta-analyses concerning the effectiveness of antibiotic prophylaxis for elective laparoscopic cholecystectomy in low-risk patients .