Author/Editor		Rakovec, S
Title		Intravenous and oral antibiotic prophylaxis in biliary surgery
Type		članek
Source		In: Hau T, Hell K, eds. Update on antibiotic prophylaxis in surgery. 33rd world congress of surgery. Toronto,
Publication year		1989
Volume		str. 43-8
Language		eng
Abstract		The study was performed in order to determine the value of preoperative intravenous and oral administration of antibiotics in the prevention of surgical sepsis. Two groups, one comprising 105 and the other 100 patients operated on for acute cholecystitis, chronic cholecystitis (above the age of 70), common bile duct obstruction or cholangitis, were included in the trial. The groups were matched for sex, age, disease and type of procedure. The 105 patients of the first group received antibiotics before surgery: 35 subjects were given mezlocillin 5 g i.v. and 13 of them 600 mg clindamycin i.v. as well; 35 patients received 120 mg gentamicin i.v. and 16 of them 600 mg clindamycin i.v. as well; 35 patients received two doses of 250 mg azithromycin orally. The i.v. medication was administered 30 minutes before surgery, while the oral antibiotic was given twelve and two hours in advance. Patients in the second group were given no antibiotics preoperatively and served as controls. Bile samples for bacteriological investigation were taken during the operation. Bacteria were isolated from the bile of 81 percent of the patients in the group receiving prophylaxis and 78 percent of the patients in the control group. The predominating microorganism was E.coli, other gram-negative microorganisms and enterococci being less numerous; in cases of common bile duct obstruction and cholangitis, clostridia and anaerobic cocci were isolated as well. No side effects due to the short duration of antibiotic therapy were noted. Septic complications were observed in 8.6 percent of the patients receiving prophylaxis and in 24 percent of the patients without prophylaxis. With respect to the durg used, the infection rates in the former group were as follows: 8.6 percent in the subgroup receiving mezlocillin (+-clindamycin), 11.4 percent in patients who were given gentamicin (+-clindamycin) and 5.7 percent in those receiving azithromycin.(trunc.)
Descriptors		SURGICAL WOUND INFECTION BILIARY TRACT DISEASES ANTIBIOTICS