@article{SuratMeyerSautterRueschetal.2022,
  author    = {Surat, G{\"u}zin and Meyer-Sautter, Pascal and R{\"u}sch, Jan and Braun-Feldweg, Johannes and Markus, Christian Karl and Germer, Christoph-Thomas and Lock, Johan Friso},
  title     = {Cefazolin might be adequate for perioperative antibiotic prophylaxis in intra-abdominal infections without sepsis: a quality improvement study},
  series = {Antibiotics},
  volume    = {11},
  journal   = {Antibiotics},
  number    = {4},
  issn      = {2079-6382},
  doi       = {10.3390/antibiotics11040501},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-270816},
  year      = {2022},
  abstract  = {Background: The adequate choice of perioperative antibiotic prophylaxis (PAP) could influence the risk of surgical site infections (SSIs) in general surgery. A new local PAP guideline was implemented in May 2017 and set the first-generation cefazolin (CFZ) instead the second-generation cefuroxime (CXM) as the new standard prophylactic antibiotic. The aim of this study was to compare the risk of SSIs after this implementation in intra-abdominal infections (IAIs) without sepsis. Methods: We performed a single center-quality improvement study at a 1500 bed sized university hospital in Germany analyzing patients after emergency surgery during 2016 to 2019 (n = 985), of which patients receiving CXM or CFZ were selected (n = 587). Propensity score matching was performed to ensure a comparable risk of SSIs in both groups. None-inferiority margin for SSIs was defined as 8\% vs. 4\%. Results: Two matched cohorts with respectively 196 patients were compared. The rate of SSIs was higher in the CFZ group (7.1\% vs. 3.6\%, p = 0.117) below the non-inferiority margin. The rate of other postoperative infections was significantly higher in the CFZ group (2.0\% vs. 8.7\%, p = 0.004). No other differences including postoperative morbidity, mortality or length-of-stay were observed. Conclusion: Perioperative antibiotic prophylaxis might be safely maintained by CFZ even in the treatment of intra-abdominal infections.},
  language  = {en}
}