Antibiotic prophylaxis after 48 hours postoperatively are not associated with decreased surgical site infections and other healthcare associated infections in pancreatic surgery patients: a retrospective cohort study

Abstract

Background It is controversial whether antibiotic should be used prophylactically 48 hours after pancreatic surgery. Hence, We evaluated the association of antibiotic prophylaxis (AP) after 48 hours postoperatively with the incidence of surgical site infections (SSIs) and other healthcare-associated infections (HAIs) in patients receiving pancreatic surgery. Methods A retrospective cohort analysis was performed on 1073 patients who underwent pancreatic surgery. These patients were categorized into non-postoperative AP group (963) and postoperative AP group (110) based on whether or not they obtained AP from 48 hours to 30 days after surgery. Outcomes included SSIs and other HAIs. Results The incidence of SSIs was lower in the non-postoperative AP group (98/963, 10.2%) than in the postoperative AP group (22/110, 20.0%) (P = 0.002). Other HAIs incidence was not significantly different between the non-postoperative AP group (77/963, 8.0%) and the postoperative AP group (11/110, 10.0%) (P = 0.468). Multiple regression analysis demonstrated that postoperative AP was a risk factor for SSIs (OR = 2.14, 95%CI = 1.28–3.59) but not with other HAIs (OR = 1.24, 95%CI = 0.63–2.42) after adjustment for age, gender and diabetes. Subsequent to adjustment for all confounding factors, postoperative AP was not a risk factor for SSIs (OR = 2.42, 95%CI = 0.79–7.37) and other HAIs (OR = 4.10, 95%CI = 0.98–17.22). Conclusions Postoperative AP following pancreatic surgery was not associated with the lower morbidity rate of SSIs and other HAIs. Nonetheless, this study may facilitate further development of strategies towards standardization of the duration of AP management of pancreatic surgery.