Antibiotic prophylaxis in elective cholecystectomy: protocol adequacy and related outcomes in a retrospective single-centre analysis

• Gil Rodríguez-Caravaca ^[1] ; Pablo Gil-Yonte ^[1] ; Carlos Risco-Risco ^[1] ; Pello Latasa Zamalloa ^[1] ; María Concepción Villar del Campo ^[3] ; José María Fernández-Cebrián ^[1] ; Ignacio Valverde-Núñez ^[4] ; Alfredo J. Lucendo ^[2]
  1. [1] Fundación Hospital Alcorcón

     Fundación Hospital Alcorcón

     Alcorcón, España

     
  2. [2] Hospital General de Tomelloso

     Hospital General de Tomelloso

     Argamasilla de Alba, España

     
  3. [3] Centro de Salud Los Cármenes. Madrid
  4. [4] Hospital Fundación Jiménez Diaz. Madrid

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• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 108, Nº. 1, 2016, págs. 15-19
• Idioma: inglés
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• Resumen

  • Background: Antibiotic prophylaxis is an effective tool to reduce surgical infection rates. However, antibiotic prophylaxis in cholecystectomy is controversial when non-high risk patients are considered. This research aims to evaluate the adherence with antibiotic prophylaxis protocol in patients undergoing cholecystectomy, and its impact in the outcomes of surgical infection.

    Methods: This single-center observational and retrospective study analyzed all elective cholecystectomy procedures carried out at the Fundación Alcorcón University Hospital in the period 2007-2014. Data were recovered from hospital records; rates of adherence to the available hospital protocols were evaluated for choice, initiation, duration, administration route and dosages of antibiotics, and the starting and duration of the prophylaxis.

    Results: The overall adequacy rate to protocol was 72%.

    The adherence rates in both the administration route and dose were 100%. The most common violations of the protocol included the choice of antibiotic agent (19%), followed by the moment of initiating its administration (8.9%). The overall wound infection rate was lower in case of laparoscopy than in laparotomy cholecystectomy (1.4% vs. 4.3%, p < 0.05; odds rate [OR] 0.29, 95% confidence interval [CI] 0.1-0.6). No relationship between adequacy of antibiotic prophylaxis and surgical infection rate was documented, neither considering overall gallbladder surgeries (crude OR 0.26, 95% CI 0.1-2.0), nor laparoscopy vs. open surgery (MH adjusted OR 0.24, 95% CI 0.2-2.1).

    Conclusions: The overall adequacy rate to antibiotic prophylaxis protocol recommended for elective cholecystectomy in our hospital was high (72%). No significant association between the adequacy or antibiotic prophylaxis and surgical infection was found.