Antibiotic prophylaxis in elective cholecystectomyprotocol adequacy and related outcomes in a retrospective single-centre analysis
- Gil Rodríguez Caravaca 1
- P. Gil-Yonte 1
- Carlos Risco Risco 1
- Pello Latasa 1
- M.ª Concepción Villar del Campo 2
- José M. Fernández Cebrián 1
- Ignacio Valverde Núñez 3
- Alfredo José Lucendo Villarín 4
- 1 Hospital Universitario Fundación Alcorcón. Alcorcón, Madrid
- 2 Centro de Salud Los Cármenes. Madrid
- 3 Hospital Fundación Jiménez Diaz. Madrid
- 4 Hospital General de Tomelloso. Tomelloso, Ciudad Real
ISSN: 2340-416, 1130-0108
Año de publicación: 2016
Volumen: 108
Número: 1
Páginas: 15-19
Tipo: Artículo
Otras publicaciones en: Revista Española de Enfermedades Digestivas
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.