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01-10-2018 | Original Paper

Prolonged antibiotic prophylaxis after thoracoabdominal esophagectomy does not reduce the risk of pneumonia in the first 30 days: a retrospective before-and-after analysis

Authors: Marcel Hochreiter, Maria Uhling, Leila Sisic, Thomas Bruckner, Alexandra Heininger, Andreas Hohn, Katja Ott, Thomas Schmidt, Marc Moritz Berger, Daniel Christoph Richter, Markus Büchler, Markus Alexander Weigand, Cornelius Johannes Busch

Published in: Infection | Issue 5/2018

Abstract

Purpose

Thoracoabdominal esophageal resection for malignant disease is frequently associated with pulmonary infection. Whether prolonged antibiotic prophylaxis beyond a single perioperative dose is advantageous in preventing pulmonary infection after thoracoabdominal esophagectomy remains unclear.

Methods

In this retrospective before-and-after analysis, 173 patients between January 2009 and December 2014 from a prospectively maintained database were included. We evaluated the effect of a 5-day postoperative course of moxifloxacin, which is a frequently used antimicrobial agent for pneumonia, on the incidence of pulmonary infection and mortality after thoracoabdominal esophagectomy.

Results

104 patients received only perioperative antimicrobial prophylaxis (control group) and 69 additionally received a 5-day postoperative antibiotic therapy with moxifloxacin (prolonged-course). 22 (12.7%) of all patients developed pneumonia within the first 30 days after surgery. No statistically significant differences were seen between the prolonged group and control group in terms of pneumonia after 7 (p = 0.169) or 30 days (p = 0.133), detected bacterial species (all p > 0.291) and 30-day mortality (5.8 vs 10.6%, p = 0.274).

Conclusion

A preemptive 5-day postoperative course of moxifloxacin does not reduce the incidence of pulmonary infection and does not improve mortality after thoracoabdominal esophagectomy.

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Title: Prolonged antibiotic prophylaxis after thoracoabdominal esophagectomy does not reduce the risk of pneumonia in the first 30 days: a retrospective before-and-after analysis
Authors: Marcel Hochreiter
Maria Uhling
Leila Sisic
Thomas Bruckner
Alexandra Heininger
Andreas Hohn
Katja Ott
Thomas Schmidt
Marc Moritz Berger
Daniel Christoph Richter
Markus Büchler
Markus Alexander Weigand
Cornelius Johannes Busch
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: Infection / Issue 5/2018
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI: https://doi.org/10.1007/s15010-018-1160-2

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Purpose

Methods

Results

Conclusion

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