Cefazolin might be adequate for perioperative antibiotic prophylaxis in intra-abdominal infections without sepsis: a quality improvement study
Please always quote using this URN: urn:nbn:de:bvb:20-opus-270816
- 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 aBackground: 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.…
| Author: | Güzin Surat, Pascal Meyer-Sautter, Jan Rüsch, Johannes Braun-Feldweg, Christian Karl Markus, Christoph-Thomas Germer, Johan Friso Lock |
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| URN: | urn:nbn:de:bvb:20-opus-270816 |
| Document Type: | Journal article |
| Faculties: | Medizinische Fakultät / Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie (Chirurgische Klinik I) |
| Medizinische Fakultät / Klinik und Poliklinik für Anästhesiologie (ab 2004) | |
| Language: | English |
| Parent Title (English): | Antibiotics |
| ISSN: | 2079-6382 |
| Year of Completion: | 2022 |
| Volume: | 11 |
| Issue: | 4 |
| Article Number: | 501 |
| Source: | Antibiotics (2022) 11:4, 501. https://doi.org/10.3390/antibiotics11040501 |
| DOI: | https://doi.org/10.3390/antibiotics11040501 |
| Sonstige beteiligte Institutionen: | Krankenhaushygiene und Antimicrobial Stewardship |
| Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
| Tag: | antibiotic prescribing quality; antimicrobial stewardship; low-risk intra-abdominal infections; perioperative antibiotic prophylaxis |
| Release Date: | 2023/05/11 |
| Date of first Publication: | 2022/04/10 |
| Licence (German): |  CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International |