Year 2016 / Volume 108 / Number 1
Original
Antibiotic prophylaxis in elective cholecystectomy: Protocol adequacy and related outcomes in a retrospective single-centre analysis

15-19

DOI: 10.17235/reed.2015.3870/2015

Gil Rodríguez Caravaca, Pablo Gil Yonte, Carlos Risco Risco, Pello Latasa Zamalloa, Mª Concepcion Villar del Campo, Jose Mª Fernández Cebrián, Ignacio Valverde Núñez, Alfredo J. Lucendo,

Abstract
Background: Antibiotic prophylaxis is an effective tool to reduce surgical infection rates. However, antibiotic prophylaxis in cholecystectomy is controversial when non-high risk patients are considered. This research aims to evaluate the adherence with antibiotic prophylaxis protocol in patients undergoing cholecystectomy, and its impact in the outcomes of surgical infection. Methods: This single-center observational and retrospective study analyzed all elective cholecystectomy procedures carried out at the Fundación Alcorcón University Hospital in the period 2007-2014. Data were recovered from hospital records; rates of adherence to the available hospital protocols were evaluated for choice, initiation, duration, administration route and dosages of antibiotics, and the starting and duration of the prophylaxis. Results: The overall adequacy rate to protocol was 72%. The adherence rates in both the administration route and dose were 100%. The most common violations of the protocol included the choice of antibiotic agent (19%), followed by the moment of initiating its administration (8.9%). The overall wound infection rate was lower in case of laparoscopy than in laparotomy cholecystectomy (1.4% vs. 4.3%, p < 0.05; odds rate [OR] 0.29, 95% confidence interval [CI] 0.1-0.6). No relationship between adequacy of antibiotic prophylaxis and surgical infection rate was documented, neither considering overall gallbladder surgeries (crude OR 0.26, 95% CI 0.1-2.0), nor laparoscopy vs. open surgery (MH adjusted OR 0.24, 95% CI 0.2-2.1). Conclusions: The overall adequacy rate to antibiotic prophylaxis protocol recommended for elective cholecystectomy in our hospital was high (72%). No significant association between the adequacy or antibiotic prophylaxis and surgical infection was found.
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References
1. Shepard J, Ward W, Milstone A, et al. Financial impact of surgical site infections on hospitals: the hospital management perspective. JAMA Surg 2013;148:907-14. doi: 10.1001/jamasurg.2013.2246.
2. de Lissovoy G, Fraeman K, Hutchins V, et al. Surgical site infection: Incidence and impact on hospital utilization and treatment costs. Am J Infect Control 2009;37:387-97. doi: 10.1016/j.ajic.2008.12.010.
3. Pujol M, Limón E. General epidemiology of nosocomial infections. Surveillance systems and programs. Enferm Infecc Microbiol Clin 2013;31:108-13. doi: 10.1016/j.eimc.2013.01.001.
4. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999;20:250–78. doi:10.1016/S0196-6553(99)70088-X.
5. Van Kasteren MEE, Manniën J, Ott A, et al. Antibiotic prophylaxis and the risk of surgical site infections following total hip arthroplasty:Timely administration is the most important factor. Clin Infect Dis 2007;44: 921–7. doi: 10.1086/512192.
6. System CN. National Nosocomial Infections Surveillnace (NISS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 2004;32:470–85. doi:10.1016/j.ajic.2004.10.001.
7. Horan TC, Andrus M, Duceck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309–32. doi: 10.1016/j.ajic.2008.03.002.
8. Bratzler DW, Houck PM. Antimicrobial prophylaxis for surgery: An advisory statement from the National Surgical Infection Prevention Project. Am J Surg 2005;189:395–404. doi:10.1016/j.amjsurg.2005.01.015.
9. Bogdanic B, Bosnjak Z, Budimir A, et al. Surveillance of Surgical Site Infection after Cholecystectomy Using the Hospital in Europe Link for Infection Control through Surveillance Protocol. Surg Infect (Larchmt) 2013;14:283-7. doi: 10.1089/sur.2012.096.
10. Choudhary A, Bechtold ML, Puli SR, et al. Role of prophylactic antibiotics in laparoscopic cholecystectomy: a meta-analysis. J Gastrointest Surg 2008;12:1847-53. doi: 10.1007/s11605-008-0681-x.
11. Matsui Y, Satoi S, Kaibori M, et al. Antibiotic prophylaxis in laparoscopic cholecystectomy: a randomized controlled trial. PLoS One. 2014;9(9):e106702. doi: 10.1371/journal.pone.0106702.
12. Chang WT, Lee KT, Chuang SC, et al. The impact of prophylactic antibiotics on postoperative infection complication in elective laparoscopic cholecystectomy: a prospective randomized study. Am J Surg 2006;191:721-5. doi:10.1016/j.amjsurg.2006.01.050.
13. Tocchi A, Lepre L, Costa G, et al. The need for antibiotic prophylaxis in elective laparoscopic cholecystectomy: a prospective randomized study. Arch Surg 2000;135:67-70. doi:10.1001/archsurg.135.1.67.
14. Sanabria A, Dominguez LC, Valdivieso E, et al. Antibiotic prophylaxis for patients undergoing elective laparoscopic cholecystectomy. Cochrane Database Syst Rev 2010;8: doi: 10.1002/14651858.CD005265.pub2.
15. Guzmán-Valdivia G. Routine administration of antibiotics to patients suffering accidental gallbladder perforation during laparoscopic cholecystectomy is not necessary. Surg Laparosc Endosc Percutan Tech 2008;18:547-50. doi: 10.1097/SLE.0b013e3181809e72.
16. Koc M, Zulfikaroglu B, Kece C, et al. A prospective randomized study of prophylactic antibiotics in elective laparoscopic cholecystectomy. Surg Endosc 2003;17:1716-8. doi: 10.1007/s00464-002-8866-y
17. Malavaud S, Bonnet E, Vigouroux D, et al. Prophylactic antibiotic use in gastro-intestinal surgery: an audit of current practice. J Chir (Paris) 2008;145:579-84. doi:10.1016/S0021-7697(08)74689-1.
18 Villeta Plaza R, Landa García JI, Rodríguez Cuéllar E, et al. National project for the clinical management of healthcare processes. The surgical treatment of cholelithiasis. Development of a clinical pathway. Cir Esp 2006;80:307-25. doi: 10.1016/S0009-739X(06)70975-7.
19. Díaz-Agero-Pérez C, Pita-López MJ, Robustillo-Rodela A, et al. Evaluación de la infección de herida quirúrgica en 14 hospitales de la Comunidad de Madrid: estudio de incidencia. Enferm Infecc Microbiol Clin 2011;29:257–62. doi: 10.1016/j.eimc.2010.09.009.
20. Indicadores Clínicos INCLIMECC. http://www.indicadoresclinicos.com. [Accessed 12 April 2014].
21. Ingraham AM, Cohen ME, Ko CY, et al. A current profile and assessment of North American Cholecystectomy: Results from the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg 2010;211: 176-86. doi: 10.1016/j.jamcollsurg.2010.04.003.
22. Mu Y, Edwards JR, Horan TC, et al. Improving Risk-Adjusted Measures of Surgical Site Infection for the National Healthcare Safety Network. Infect Control Hosp Epidemiol 2011;32:970-86. doi: 10.1086/662016.
23. Jaafar G, Persson G, Svennblad B, et al. Outcomes of antibiotic prophylaxis in acute cholecystectomy in a population-based gallstone surgery registry. Br J Surg 2014;101:69-73. doi: 10.1002/bjs.9369.
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Rodríguez Caravaca G, Gil Yonte P, Risco Risco C, Latasa Zamalloa P, Villar del Campo M, Fernández Cebrián J, et all. Antibiotic prophylaxis in elective cholecystectomy: Protocol adequacy and related outcomes in a retrospective single-centre analysis. 3870/2015


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Publication history

Received: 29/05/2015

Accepted: 12/09/2015

Online First: 30/11/2015

Published: 30/12/2015

Article revision time: 95 days

Article Online First time: 185 days

Article editing time: 215 days


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