Document Detail


Effectiveness of prophylactic antibiotics in a population-based cohort of patients undergoing planned cholecystectomy.
MedLine Citation:
PMID:  19902314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In the absence of randomized controlled trials with sufficient power to assess the effectiveness of prophylactic antibiotics (PA), the best evidence is provided by large population-based register studies. METHODS: The Swedish Register of Gallstone Surgery and ERCP (GallRiks) started in May 2005 and reached 75% national coverage in 2007. During 2006 and 2007, a total of 16,400 operations were registered in GallRiks. In the present study, all elective procedures performed in 2006-2007 in units performing at least 25 operations annually were included in an analysis of the risk for postoperative infectious complications RESULTS: Altogether 10,927 procedures were performed 2006-2007. Univariate logistic regression analysis revealed a paradoxical increase in postoperative infectious complications requiring antibiotic treatment and postoperative abscess if PA were given (p < 0.05). This increase disappeared in multivariate analysis with adjustment for age, gender, presence of cholecystitis, accidental gallbladder perforation, and presence of bile duct stones. CONCLUSION: No benefit from PA was seen in this study on elective cholecystectomy. Although a randomized controlled trial could possibly show a reduction in the risk for postoperative infectious complications not detected in this study, such a reduction must be weighed against the risk of promoting drug resistance by the widespread use of PA.
Authors:
Patrik Lundstr?m; Gabriel Sandblom; Johanna Osterberg; Bodil Svennblad; Gunnar Persson
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Publication Detail:
Type:  Journal Article     Date:  2009-11-10
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  14     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-22     Completed Date:  2010-05-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  329-34     Citation Subset:  IM    
Affiliation:
Department of Surgery, Mora Hospital, Mora Lasarett, 79285 Mora, Sweden. Patrik.Lundstrom@ltdalarna.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Bacterial Agents / administration & dosage*
Antibiotic Prophylaxis
Cholecystectomy / adverse effects*
Female
Gallstones / surgery*
Humans
Male
Middle Aged
Postoperative Complications / prevention & control
Registries
Surgical Procedures, Elective
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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