The Efficacy of Cefazolin in Reducing Surgical Site Infection in Laparoscopic Cholecystectomy: a Prospective Randomized Double-blind Controlled Trial

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2014 Jul 24

PMID 25052130

Citations 16

Authors

Sakchai Ruangsin

Supparerk Laohawiriyakamol

Somkiat Sunpaweravong

Somrit Mahattanobon

Affiliations

Soon will be listed here.

Abstract

Background: A prophylactic antibiotic is recommended in open cholecystectomy surgeries, but in laparoscopic cholecystectomies such prophylaxis is controversial. Recent reviews have not found conclusive evidence that routine prophylaxis, especially in low risk patients, is effective. This clinical trial was undertaken to evaluate the efficacy of cefazolin in reducing surgical site infection SSI in laparoscopic cholecystectomies in a sample not screened for high or low risk patients.

Methods: A randomized double-blind controlled trial was conducted in a single university hospital. Scheduled cholecystectomy patients without selection for patient risk factors were randomized into two groups. Pre-operatively, group A patients received a placebo of 10 ml isotonic sodium chloride, and group B patients received 1 g of cefazolin as a prophylactic antibiotic. All patients underwent a standard laparoscopic cholecystectomy, and were followed up for at least 30 days.

Results: Two hundred ninety-nine patients were randomized (149 in group A and 150 in group B). SSI occurred in seven patients (2.34 %), five (1.67 %) in the placebo group, and two (0.67 %) in the prophylactic antibiotic group. The difference was not statistically significant (p value = 0.512), and no specific risk factors for post-operative infection were identified.

Conclusions: A single dose of preoperative prophylactic cefazolin has no significant benefit in reducing the incidence of SSI in laparoscopic cholecystectomy. Whether or not to use a prophylactic depends on the individual patient, and the consideration of the attending surgeon.

Citing Articles

Prophylactic antibiotics in laparoscopic cholecystectomy: Reducing postoperative infection risk-A meta-analysis and trial sequential analysis.

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Clinical Predictive Score for Cholecystectomy Wound Infection: WEBAC Score.

Chaochankit W, Samphao S, Mahattanobon S, Sungworawongpana C J Gastrointest Surg. 2023; 27(9):1876-1882.

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The effect of antibiotic prophylaxis on the incidence of surgical site infection after laparoscopic appendectomy for chronic appendicitis.

Dai L, Jin X, Xie H, He T, Cheng H, Zhu Y Heliyon. 2023; 9(5):e15578.

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Antibiotic Prophylaxis for Hepato-Biliopancreatic Surgery-A Systematic Review.

Steccanella F, Amoretti P, Barbieri M, Bellomo F, Puzziello A Antibiotics (Basel). 2022; 11(2).

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Reduction of risk of infection during elective laparoscopic cholecystectomy using prophylactic antibiotics: a systematic review and meta-analysis.

Yang J, Gong S, Lu T, Tian H, Jing W, Liu Y Surg Endosc. 2021; 35(12):6397-6412.

PMID: 34370122 DOI: 10.1007/s00464-021-08658-w.

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