Oral vs intravenous antibiotic prophylaxis in elective laparoscopic cholecystectomy—an exploratory trial

Abstract

The oral application of an antibiotic (gyrase inhibitor) was feasible and safe for perioperative antibiotic prophylaxis in laparoscopic cholecystectomy in this exploratory trial.

Role of Prophylactic Antibiotics in Laparoscopic Cholecystectomy: A Meta-Analysis

“…Subsequently, 11 additional studies did not meet the inclusion criteria and were excluded, including non-randomized prospective studies 6,20 and RCTs using two different antibiotics 21 or comparing two modes and doses of antibiotics. 22,23 Nine RCTs (N = 1,437), published as full-length publications in journals, met the inclusion criteria and were selected for final review and analysis (Fig. 1).…”

Clinical practice guidelines for antimicrobial prophylaxis in surgery

“…Firstgeneration, 307 cephalosporins have been studied more extensively than other antimicrobials. Limited data are available for ampicillin with gentamicin, 355 piperacillin, 356 amoxicillinclavulanate, 305,338,351,354 ciprofloxacin, 320,333,352,357 and cephalosporins or penicillins alone or in combination with metronidazole, gentamicin, or b o t h m e t ron i d a zo l e a n d gentamicin. 308 Several studies have compared first-generation cephalosporins with second-or third-generation agents.…”

“…292,304-311 Infection rates after laparoscopic cholecystectomy range from 0% to approximately 4% in patients without antimicrobial prophylaxis 308,312-320 and from 0% to 7% with prophylaxis. 292,[304][305][306][307][308][309][310][311][312][313][314][315][316][317][318][319][320][321][322][323] Several studies found that laparoscopic cholecystectomy SSI rates were significantly lower than those associated with open cholecystectomy. 292,[306][307][308][309][310][311] Risk factors associated with postoperative SSIs after biliary procedures include performance of emergency procedures, 305 diabetes, 305,306,311,315,317 longer procedure duration (over 120 minutes), 305 315,316 reintervention in less than a month for noninfectious complications, 310 acute cholecystitis, 6,7,306 bile spillage, 7 jaundice, 6,7,306 pregnancy, 7 nonfunctioning gallbladder, 6 and immunosuppression.…”

Bactobilia Among Patients with Uncomplicated Cholelithiasis Undergoing Laparoscopic Cholecystectomy: The Risk Factors and Effects on Postoperative Infectious Complications

“…Some clinical trials suggest that antibiotic prophylaxis may not be necessary in LC, especially in patients with uncomplicated gallstones who underwent elective LC (9,10). Either way, the better knowledge about the nature of bacteria in bile and their antimicrobial susceptibility patterns could play an important role in the proper selection of antibiotics for prophylaxis, especially in high-risk patients.…”

“…The rate of post-operative wound infection after elective cholecystectomy in uncomplicated symptomatic gallstone ranges from 2.3% to 20% (6)(7)(8)(9).…”