Pharmacological evaluation of prophylactic anti-microbial use in laparoscopic cholecystectomy; an open labelled study evaluating the concentrations of single dose intravenous ceftriaxone at serum and tissue level

Sheikh, Salim; Kumar, Malik Neeraj; Tripathi, Chakra Dhar; Arya, Satyavrat; Verma, Veena; Karim, Bushra; Meshram, Girish Gulab

doi:10.1007/s00228-021-03093-1

Cited by 5 publications

(5 citation statements)

References 29 publications

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“…Due to lack of specific guidelines for anti-microbial prophylaxis for surgery in pediatric population, the choice of anti-microbial, timing, dose and frequency are based mainly on the guidelines for adult patients and the surgeon's experience ( Berríos-Torres et al., 2017 ; Allegranzi et al., 2016 ; Scottish Intercollegiate, 2008 ; Ban et al., 2017 ; Anderson et al., 2014 ; Bratzler et al., 2013 ). We favored ceftriaxone because of its easy availability, intravenous route, relatively good safety profile, broad spectrum and long elimination half life with a time dependent effect as per the concentration in the blood ( Salkind and Rao, 2011 ; Brunton et al., 2018 ; Salim et al., 2021 ). It was administered as a single injection prior to skin incision within time frame of 30 min ( Hawn et al., 2013 ; Steinberg et al., 2009 ; van Kasteren et al., 2007 ; Classen et al., 1992 ).…”

Section: Discussionmentioning

confidence: 99%

“…No specific guidelines are available for prophylactic antibiotic use in pediatric surgeries, due to which the choice of anti-microbial, dose, timing and frequency are based mainly on the guidelines for adult patients and the surgeon's experience ( Berríos-Torres et al., 2017 ; Allegranzi et al., 2016 ; Scottish Intercollegiate, 2008 ; Ban et al., 2017 ; Anderson et al., 2014 ; Bratzler et al., 2013 ; Hawn et al., 2013 ; Steinberg et al., 2009 ; van Kasteren et al., 2007 ; Classen et al., 1992 ). Third generation cephalosporin, ceftriaxone is used preferentially because of its easy availability, intravenous route, relatively good safety profile, broad-spectrum and long elimination half-life with a time-dependent effect as per the concentration in the blood ( Salkind and Rao, 2011 ; Brunton et al., 2018 ; Salim et al., 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Variability in the serum and tissue concentrations of pre-incisional ceftriaxone for surgery in paediatric population and outcome of surgical-site infections; An open labelled, prospective, non-randomized, analytical study

Sheikh

Majoka

Tripathi

et al. 2022

Current Research in Pharmacology and Drug Discovery

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Studies have determined the serum concentration of ceftriaxone in the adult population, but there are only a few studies that measured the tissue concentrations. However, no studies have concurrently evaluated the serum and tissue concentrations of ceftrixaone in elective pediatric surgery patients. Therefore, our study was planned to evaluate the serum and tissue concentrations of single dose intravenous prophylactic ceftriaxone intra-operatively during an ongoing pediatric surgery and the outcome of surgical-site infections (SSIs). We did a correlation analysis to determine the relationship of various concentrations and surgery related risk factors with the outcome of SSIs. It was an open label prospective study in 50 patients who underwent elective pediatric surgery under prophylactic cover of ceftriaxone. Serum and tissue concentration were estimated by High Pressure Liquid Chromatography (HPLC). Subjects were observed for post operative complications including SSI. Serum and tissue concentrations of ceftriaxone were significant at test value of 4 mg/L. Tissue concentrations of ceftriaxone at incision (p = 0.02) and closure (p = 0.04) were significantly correlated with SSI but there was no significant association. The measured serum ceftriaxone concentrations were more than 20 times the susceptible minimum inhibitory concentration (MIC) at any given point of the surgery. On the other hand, this target level was achieved at the tissue levels in the majority of the patient. The factors associated with SSI were duration of surgery, wound category of contaminated clean type, the use of urinary catheter and implants in the surgery. An intra-operative re-dose, extension of dose or addition of another antibiotic may be considered for such patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Variability in the serum and tissue concentrations of pre-incisional ceftriaxone for surgery in paediatric population and outcome of surgical-site infections; An open labelled, prospective, non-randomized, analytical study

Sheikh

Majoka

Tripathi

et al. 2022

Current Research in Pharmacology and Drug Discovery

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“…Most surgeons quoted presence of post-operative complications as the rationale for continuing antibiotics for longer post-operatively [ 34 ]. Whether COVID-19 has increased the proportion of patients receiving prolonged surgical prophylaxis requires further investigation, but it seems that in our institution at least attention needs to be paid to improving compliance with surgical prophylaxis guidelines [ 35 , 36 ]. This could be by restricting the availability of broad-spectrum antibiotics and/or strictly limiting the duration of surgical prophylaxis to a day [ 31 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic point prevalence survey at a tertiary healthcare hospital in India: Identifying strategies to improve the antibiotic stewardship program immediately after a COVID-19 wave

Sheikh¹,

Vishwas²,

Bhattacharya³

et al. 2022

Infection Prevention in Practice

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“…Було проведено відкрите проспективне дослідження за участю 50 послідовних пацієнтів, яким виконано планову ЛХ під профілактичним прикриттям цефтріаксоном [54]. Концентрації в сироватці та тканинах оцінювали під час операції, що тривала.…”

Section: антибіотики при плановій лапароскопічній холецистектоміїunclassified

Laparoscopic cholecystectomy in calculous cholecystitis: are antibiotics necessary?

Chuklin,

Chooklin

2024

ЕМ

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Laparoscopic cholecystectomy in patients with cholecystitis is considered the best, appropriate and safe method of treatment for gallstone disease. However, the role of antibiotic administration before or after cholecystectomy to reduce infectious complications, particularly surgical site infections, or mortality is less clear. Many patients receive empiric antibiotics, but the feasibility of their use has not been proven. Some guidelines suggest the use of antibiotic prophylaxis for all cholecystectomies, although current evidence does not indicate any benefit to this practice in the absence of risk factors. This review examines the results of antibiotic use in laparoscopic cholecystectomy for chronic and acute calculous cholecystitis. Most studies argue against the need to use prophylactic antibiotics during elective surgery in low-risk patients. In cases of mild and moderate acute cholecystitis, the use of antibiotics to prevent postoperative infectious complications has no evidence of effectiveness, although these recommendations are also ambiguous. It is not recommended to use postoperative antibiotics after elective laparoscopic cholecystectomy, as well as for mild or moderate acute cholecystitis. However, additional studies with well-defined patient populations and comparable outcomes are needed to better assess the most appropriate timing and duration of antibiotic use in patients undergoing laparoscopic cholecystectomy. We used MedLine database on the PubMed platform and the Cochrane library to search for literature sources.

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Pharmacological evaluation of prophylactic anti-microbial use in laparoscopic cholecystectomy; an open labelled study evaluating the concentrations of single dose intravenous ceftriaxone at serum and tissue level

Cited by 5 publications

References 29 publications

Variability in the serum and tissue concentrations of pre-incisional ceftriaxone for surgery in paediatric population and outcome of surgical-site infections; An open labelled, prospective, non-randomized, analytical study

Variability in the serum and tissue concentrations of pre-incisional ceftriaxone for surgery in paediatric population and outcome of surgical-site infections; An open labelled, prospective, non-randomized, analytical study

Antibiotic point prevalence survey at a tertiary healthcare hospital in India: Identifying strategies to improve the antibiotic stewardship program immediately after a COVID-19 wave

Laparoscopic cholecystectomy in calculous cholecystitis: are antibiotics necessary?

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