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25.09.2023 | Original Scientific Report

Comparison of Cefazolin and Ceftriaxone as Antimicrobial Prophylaxis in Pancreatoduodenectomy with Preoperative Drainage: Incidence of Surgical Site Infection and Susceptibility of Bacteria in Bile

verfasst von: Taihei Soma, Katsuhisa Ohgi, Hanako Kurai, Teiichi Sugiura, Ryo Ashida, Mihoko Yamada, Shimpei Otsuka, Akifumi Notsu, Katsuhiko Uesaka

Erschienen in: World Journal of Surgery | Ausgabe 12/2023

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Abstract

Background

The optimal perioperative antimicrobial agent for preventing surgical site infection (SSI) in pancreatoduodenectomy (PD) with preoperative biliary drainage (PBD) remains unclear.

Methods

We retrospectively reviewed 288 patients who underwent PD after PBD between 2010 and 2020 at our institution. Patients were classified into two groups according to the perioperative antimicrobial agent used (cefazoline [CEZ] group [n = 108] and ceftriaxone [CTRX] group [n = 180]). The incidence of SSI, type of bacteria in intraoperative bile culture (IBC), and antimicrobial susceptibility to prophylactic antimicrobial agents were analyzed.

Results

The incidence of incisional SSI was significantly lower in the CTRX group than in the CEZ group (18% vs. 31%, P = 0.021), whereas the incidence of organ/space SSI in the two groups did not differ to a statistically significant extent (35% vs. 44%, P = 0.133). Gram-negative rod (GNR) bacteria in the IBC showed better antimicrobial susceptibility in the CTRX group than in the CEZ group. In multivariate analysis, antimicrobial resistance due to GNR was a significant risk factor for incisional SSI (odds ratio, 3.50; P < 0.001).

Conclusions

CTRX had better antimicrobial coverage than CEZ for GNR cultured from intraoperative bile samples. In addition, CTRX provides better antimicrobial prophylaxis than CEZ against superficial SSI in patients with PD after PBD.

Trial registration number

This study was not a clinical trial and had no registration numbers.

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Titel: Comparison of Cefazolin and Ceftriaxone as Antimicrobial Prophylaxis in Pancreatoduodenectomy with Preoperative Drainage: Incidence of Surgical Site Infection and Susceptibility of Bacteria in Bile
verfasst von: Taihei Soma
Katsuhisa Ohgi
Hanako Kurai
Teiichi Sugiura
Ryo Ashida
Mihoko Yamada
Shimpei Otsuka
Akifumi Notsu
Katsuhiko Uesaka
Publikationsdatum: 25.09.2023
Verlag: Springer International Publishing
Erschienen in: World Journal of Surgery / Ausgabe 12/2023
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-023-07174-3

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Comparison of Cefazolin and Ceftriaxone as Antimicrobial Prophylaxis in Pancreatoduodenectomy with Preoperative Drainage: Incidence of Surgical Site Infection and Susceptibility of Bacteria in Bile