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Selection of prophylactic antibiotics according to the microorganisms isolated from surgical site infections (SSIs) in a previous series of surgeries reduces SSI incidence after pancreaticoduodenectomy

Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Background

The incidence of surgical site infections (SSIs) is high after pancreaticoduodenectomy (PD).

Methods

We divided 116 consecutive patients who underwent PD into an early group (n = 58) and a later group (n = 58) according to time of surgery. In both groups, endoscopic retrograde biliary drainage was mainly employed for the patients with obstructive jaundice. In the later group, prophylactic antibiotics were selected according to the susceptibility of microorganisms isolated from SSIs in the early group. The incidence of SSIs was compared between the groups.

Results

The background characteristics (including methods of preoperative biliary drainage and microorganisms in the bile obtained before or during operation) of the patients were not significantly different between the groups, except for the serum albumin level, which was lower in the later group than in the early group (P = 0.0026). The incidence of SSIs was significantly lower in the later group (24.1 %) than in the early group (46.6 %) (P = 0.0116). Belonging to the later group was one independent negative risk factor for SSI.

Conclusions

Selection of prophylactic antibiotics on the basis of microorganisms isolated from SSIs in the early group contributed to the reduced incidence of SSIs in the later group after PD.

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Acknowledgments

We would like to express our immense gratitude to Professor Akihiko Okayama, Professor Tetsuya Hayashi, Mr. Yuji Saeki, and other members of the infection control team of the University of Miyazaki Hospital for their suggestions.

Conflict of interest

The authors declare that they have no conflict of interest.

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Correspondence to Kazuo Chijiiwa.

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Kondo, K., Chijiiwa, K., Ohuchida, J. et al. Selection of prophylactic antibiotics according to the microorganisms isolated from surgical site infections (SSIs) in a previous series of surgeries reduces SSI incidence after pancreaticoduodenectomy. J Hepatobiliary Pancreat Sci 20, 286–293 (2013). https://doi.org/10.1007/s00534-012-0515-9

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  • DOI: https://doi.org/10.1007/s00534-012-0515-9

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