The efficacy of cefazolin in reducing surgical site infection in laparoscopic cholecystectomy: a prospective randomized double-blind controlled trial

Ruangsin, Sakchai; Laohawiriyakamol, Supparerk; Sunpaweravong, Somkiat; Mahattanobon, Somrit

doi:10.1007/s00464-014-3745-x

Cited by 28 publications

(36 citation statements)

References 19 publications

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“…In RCTs, only 12 studies212228323638404243444547 showed the data from intention-to-treat analysis, and the other 16 studies20232425262729303133343537394146 showed data from per-protocol analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Subgroup analysis for SSI including both superficial and deep SSI was performed using 28 RCTs,20212223242526272829303132333435363738394041424344454647 3 prospective studies,484950 and 3 retrospective studies 225152. In the 28 RCTs, 83 (2.07%) of the 4018 patients in the prophylactic antibiotic group developed SSI compared with 119 (3.17%) of the 3752 patients in the no prophylaxis group.…”

Section: Resultsmentioning

confidence: 99%

“…Jadad et al19 score was also applied to assess the quality of included randomized studies in the meta-analysis. Of the 28 RCTs,20212223242526272829303132333435363738394041424344454647 25 studies22232425262728293031323334353637394041424344454647 were eligible to be included in the meta-analysis with high-quality Jadad score ≥3, and the other 3 studies202138 were low-quality studies with Jadad score 2. Sensitivity tests were performed to assess whether including three RCTs classified as low-quality is appropriate in this meta-analysis.…”

Section: Methodsmentioning

confidence: 99%

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Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis

Kim

Yang

et al. 2018

Ann Hepatobiliary Pancreat Surg

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Backgrounds/AimsThe role of prophylactic antibiotics for laparoscopic cholecystectomy in low-risk patients is still unclear. This study aimed to verify the conclusion of previous meta-analyses concerning the effectiveness of antibiotic prophylaxis for elective laparoscopic cholecystectomy in low-risk patients.MethodsComprehensive literature searches were performed on electric databases and manual searches. Randomized controlled trials (RCTs), prospective studies, and retrospective studies comparing antibiotic prophylaxis to placebo or no antibiotics in low-risk elective laparoscopic cholecystectomy were included.ResultsThis study included 28 RCTs, three prospective studies, and three retrospective studies. In RCTs, prophylactic antibiotics did not prevent deep surgical site infections (SSI) (RR 1.10, 95% confidence interval [CI] [0.45–2.69], p=0.84) but reduced SSI (RR 0.70, 95% CI [0.53–0.94], p=0.02), and superficial SSI (RR 0.58, 95% CI [0.42–0.82], p=0.01). Prospective studies showed prophylactic antibiotics did not reduce superficial SSI (RR 0.35, 95% CI [0.01–8.40], p=0.52) but reduced SSI (RR 0.12, 95% CI [0.04–0.35], p=0.0001). In retrospective studies, antibiotic prophylaxis did not reduce SSI (RR 1.59, 95% CI [0.30–8.32], p=0.58). The pooled data (12121 patients) including RCTs and prospective and retrospective studies showed that prophylactic antibiotics were not effective in preventing deep SSI (RR 1.01 95% CI [0.46–2.21], p=0.98) but effective in reducing SSI (RR 0.67, 95% CI [0.51–0.88], p=0.003) and superficial SSI (RR 0.61, 95% CI [0.45–0.83], p=0.002).ConclusionsThe use of prophylactic antibiotics is effective for reducing the incidence of SSI and superficial SSI but is not effective for preventing deep SSI in low-risk patients who underwent elective laparoscopic cholecystectomy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis

Kim

Yang

et al. 2018

Ann Hepatobiliary Pancreat Surg

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“…[46]. However, the effects of a prophylactic antibiotic in prevention of surgical site infection are being questioned [47]. It is important for the doctors and nurses to take care in preoperative umbilical nursing, careful control of blood sugar, intraoperative protection of the umbilical incision using an end catch bag, and postoperative surgical site nursing.…”

Section: Discussionmentioning

confidence: 99%

Transumbilical single-incision laparoscopic cholecystectomy: long-term review from a single center

Tian

et al. 2015

Surg Endosc

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“…(8, 9) Simultaneously, rates of post-operative infections for select procedures are low and have been getting progressively lower. (10–12)…”

Section: Introductionmentioning

confidence: 99%

Surgical Antibiotic Prophylaxis and Risk for Postoperative Antibiotic-Resistant Infections

Cohen

Salmasian

et al. 2017

Journal of the American College of Surgeons

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Background Antibiotic-resistant infections have high rates of morbidity and mortality and exposure to antibiotics is the crucial risk factor for development of antibiotic resistance. If surgical antibiotic prophylaxis (SAP) increases risk for antibiotic-resistant infections, prophylaxis may cause net harm even if it decreases overall infection rates. Study Design This retrospective cohort study included adults who underwent elective surgical procedures and developed infections within 30 post-operative days. Surgeries from multiple disciplines were included if SAP was considered discretionary by current guidelines. Postoperative antibiotic-resistant infections were defined as positive culture results from any site within 30 post-operative days showing intermediate or non-susceptibility across one or more antibiotic classes. SAP included use of antibiotics within any class and at any dose from one hour before first incision until the end of the operation. Results Among 689 adults with post-operative infections, 338 (49%) had post-operative resistant infections. Use of SAP was not associated with post-operative antibiotic-resistant infections (OR 0.99, 95% CI 0.67–1.46). This result remained robust when the SAP definition was extended to antibiotics given within 4 hours before first incision (OR 0.94, 95% CI 0.63–1.40) and when the follow-up window was narrowed to 14 days (OR 0.82, 95% CI 0.50–1.34). Prior antibiotic-resistant infections were associated with risk for post-operative antibiotic-resistant infections (OR 1.81, 95% CI 1.16–2.83). Conclusion Use of SAP was not associated with risk for post-operative antibiotic resistant infections in a large cohort of patients with post-operative infections. This provides important reassurance regarding use of surgical antibiotic prophylaxis.

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The efficacy of cefazolin in reducing surgical site infection in laparoscopic cholecystectomy: a prospective randomized double-blind controlled trial

Abstract: A single dose of preoperative prophylactic cefazolin has no significant benefit in reducing the incidence of SSI in laparoscopic cholecystectomy. Whether or not to use a prophylactic depends on the individual patient, and the consideration of the attending surgeon.

Cited by 28 publications

References 19 publications

Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis

Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis

Transumbilical single-incision laparoscopic cholecystectomy: long-term review from a single center

Surgical Antibiotic Prophylaxis and Risk for Postoperative Antibiotic-Resistant Infections

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