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Surgery Today
Published in: Surgery Today 9/2018

01-09-2018 | Original Article

The use of broad-spectrum antibiotics reduces the incidence of surgical site infection after pancreatoduodenectomy

Authors: Kimitaka Tanaka, Toru Nakamura, Shungo Imai, Hiroki Kushiya, Daisuke Miyasaka, Yoshitsugu Nakanishi, Toshimichi Asano, Takehiro Noji, Takahiro Tsuchikawa, Keisuke Okamura, Toshiaki Shichinohe, Satoshi Hirano

Published in: Surgery Today | Issue 9/2018

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Abstract

Purpose

The development of surgical site infection (SSI) after biliary reconstruction is highly influenced by the presence of preoperative bacteria in the bile juice. We selected vancomycin and piperacillin/tazobactam (VCM + PIPC/TAZ) as perioperative prophylactic antibiotics for patients undergoing pancreaticoduodenectomy. This study aimed to retrospectively analyze the effectiveness of VCM + PIPC/TAZ compared to cefmetazole.

Methods

Seventy-two patients who underwent pancreaticoduodenectomy between April 2015 and March 2017 at our department were evaluated. Forty patients were administered cefmetazole as the perioperative prophylactic antibiotic, and 32 were administered VCM + PIPC/TAZ. The intraoperative VCM blood concentration (incision, biliary reconstruction, and wound closure) was measured during surgery to confirm the hemodynamics.

Results

The frequency of SSIs was significantly lower in the VCM + PIPC/TAZ group (8/32 patients) than in the cefmetazole group (20/40 patients, P = 0.031). Postoperatively, significantly fewer patients in the VCM + PIPC/TAZ group (4/32 patients) required ≥ 15 days of additional antibiotic administration compared to those in the cefmetazole group (14/40 patients, P = 0.033). Six of 32 patients in the VCM + PIPC/TAZ group showed redneck syndrome symptoms. There was no significant difference in the VCM blood concentration between patients with and without SSIs.

Conclusions

The use of VCM + PIPC/TAZ can reduce the incidence of SSI after pancreaticoduodenectomy and also reduce the need for the additional administration of antibiotics for ≥ 15 days after surgery.
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Metadata
Title
The use of broad-spectrum antibiotics reduces the incidence of surgical site infection after pancreatoduodenectomy
Authors
Kimitaka Tanaka
Toru Nakamura
Shungo Imai
Hiroki Kushiya
Daisuke Miyasaka
Yoshitsugu Nakanishi
Toshimichi Asano
Takehiro Noji
Takahiro Tsuchikawa
Keisuke Okamura
Toshiaki Shichinohe
Satoshi Hirano
Publication date
01-09-2018
Publisher
Springer Singapore
Published in
Surgery Today / Issue 9/2018
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-018-1658-3

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