Optimal duration of antimicrobial prophylaxis in patients undergoing distal pancreatectomy: A multicenter cohort study

IF 2.9 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Kenjiro Okada, Kenichiro Uemura, Sohei Satoi, Tsutomu Fujii, Manabu Kawai, So Yamaki, Toru Watanabe, Hideki Motobayashi, Shinya Takahashi
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Abstract

Background

Antimicrobial prophylaxis is routinely administered in patients undergoing distal pancreatectomy, with cephalosporins being the most frequently used agents. However, there is limited evidence regarding optimal duration of antimicrobial prophylaxis. This study aimed to evaluate the optimal duration of antimicrobial prophylaxis in distal pancreatectomy.

Methods

A multicenter cohort study was performed using a common database of patients who underwent distal pancreatectomy between April 2017 and March 2022 at four high-volume centers in Japan. Eligible patients were divided into two groups according to the duration of antimicrobial prophylaxis: intraoperative or up to 24 h after surgery and more than 24 h after surgery. Primary endpoint was the incidence of surgical site infections.

Results

A total of 496 patients were enrolled in this study, including 254 and 242 patients categorized into the intraoperative or up to 24-h and more than 24-h groups, respectively. Surgical site infections occurred in 129 patients (26%). The intraoperative or up to 24-h group had a significantly lower incidence of surgical site infection (19% vs. 33%, p < 0.001) and infectious clinically relevant postoperative pancreatic fistula (8% vs. 17%, p = 0.002). There were no significant differences in severe surgical site infection rates between the groups. Multivariate logistic regression identified more than 24-h administration of antimicrobial prophylaxis as an independent risk factor for surgical site infections (p = 0.001).

Conclusion

Prolonged administration of antimicrobial prophylaxis may not be effective in preventing surgical site infections after distal pancreatectomy compared to intraoperative or up to 24-h administration.

Abstract Image

远端胰腺切除术患者抗菌预防的最佳持续时间:一项多中心队列研究
背景:在接受远端胰腺切除术的患者中,常规给予抗菌预防,其中头孢菌素是最常用的药物。然而,关于抗菌药物预防的最佳持续时间的证据有限。本研究旨在评估远端胰腺切除术中抗菌药物预防的最佳持续时间。方法使用日本四个高容量中心2017年4月至2022年3月期间接受远端胰腺切除术的患者的共同数据库进行多中心队列研究。根据抗菌预防持续时间将符合条件的患者分为术中或术后24小时及术后24小时以上两组。主要终点是手术部位感染的发生率。结果共纳入496例患者,其中术中、24小时组和24小时以上组分别为254例和242例。手术部位感染129例(26%)。术中或24小时组手术部位感染(19% vs. 33%, p < 0.001)和感染性术后胰瘘(8% vs. 17%, p = 0.002)的发生率显著降低。两组间严重手术部位感染率无显著差异。多因素logistic回归发现,超过24小时的抗菌预防用药是手术部位感染的独立危险因素(p = 0.001)。结论与术中或24小时给药相比,长时间给药预防抗菌药物可能不能有效预防远端胰腺切除术后手术部位感染。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
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