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Outcomes of antibiotic prophylaxis in acute cholecystectomy in a population-based gallstone surgery registry
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
2014 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 101, no 2, 69-73 p.Article in journal (Refereed) Published
Abstract [en]

Background

The aim of this study was to assess the effect of antibiotic prophylaxis (AP) on postoperative infections in acute cholecystectomy.

Methods

The study was based on acute cholecystectomies registered in the nationwide Swedish Register for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks) between 2006 and 2010. The association between AP and the risk of postoperative infectious complications was tested in a multivariable regression analysis, with stepwise addition of age, sex, duration of operation, indication for surgery, surgical approach (laparoscopic versus open) and American Society of Anesthesiologists (ASA) fitness grade as co-variables. Postoperative infections requiring antibiotic treatment and postoperative abscesses were defined as outcome measures.

Results

AP was given to 9549 (68<bold>6</bold> per cent) of 13 911 patients. Postoperative infections requiring antibiotic treatment occurred following 1070 procedures (7<bold>7</bold> per cent), including 805 patients (8<bold>4</bold> per cent) who received AP (P < 0<bold>001</bold> versus patients without AP). Postoperative abscesses developed after 273 procedures (2<bold>0</bold> per cent), including 208 patients (2<bold>2</bold> per cent) who received AP (P = 0<bold>007</bold>). In univariable analysis, the odds ratio for development of infectious complications necessitating treatment with antibiotics was 1<bold>42</bold> (95 per cent confidence interval 1<bold>23</bold> to 1<bold>64</bold>) for those who received APversus those who did not, and for postoperative abscesses it was 1<bold>47</bold> (1<bold>11</bold> to 1<bold>95</bold>). In multivariable analysis, adjusting for confounders, the odds ratios were 0<bold>93</bold> (0<bold>79</bold> to 1<bold>10</bold>) and 0<bold>88</bold> (0<bold>64</bold> to 1<bold>21</bold>) respectively.

Conclusion

The present study suggests that AP provides no benefit in acute cholecystectomy. No benefit from antibiotics

Place, publisher, year, edition, pages
2014. Vol. 101, no 2, 69-73 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-218557DOI: 10.1002/bjs.9369ISI: 000328750200013OAI: oai:DiVA.org:uu-218557DiVA: diva2:695896
Available from: 2014-02-12 Created: 2014-02-12 Last updated: 2017-12-06Bibliographically approved

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