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Perioperative Antimicrobial Prophylaxis for Intra-abdominal Surgery in Patients with Cancer: A Retrospective Study Comparing Ertapenem and Nonertapenem Antibiotics

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

To evaluate the role of ertapenem versus other standard antibiotic prophylaxis in patients with cancer undergoing intra-abdominal surgery.

Methods

Our study was a retrospective cohort study consisting 615 patients who underwent intra-abdominal surgery at our institution between January 2007 and December 2010. The groups were divided among patients who received ertapenem as perioperative prophylaxis (ertapenem group) and patients who received other antibiotics (nonertapenem group). Groups were similar with respect to age, gender, and type of surgery.

Results

A total of 315 patients underwent colorectal and 300 noncolorectal surgeries. In a multivariate logistic regression model, the main factors associated with risk of surgical site infections (SSI) were as follows: antibiotics within 3 months of surgery (odds ratio [OR] 1.2, 95 % confidence interval [CI] 1.04–1.54; p = 0.05), prior hospitalization within 1 year (OR 1.21, 95 % CI 1.02–1.43; p = 0.05), diabetes mellitus (OR 2.1, 95 % CI 1.7–3.4; p = 0.04), and perioperative prophylaxis other than ertapenem (OR 1.7, 95 % CI 1.2–2.3; p = 0.04). Notably, patients who underwent colorectal surgery and received ertapenem had a lower rate of SSI (4 % ertapenem vs. 13 % nonertapenem, p = 0.01), whereas the frequency of infections was not different in patients who underwent other intra-abdominal surgery whether they received ertapenem or not.

Conclusions

The use of ertapenem for perioperative prophylaxis in patients with colorectal surgery was associated with lower rates of SSI, while there was no difference in rates of infection in other intra-abdominal surgery.

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Disclosure

R.F.C. received a research grant from Merck to support part of the stipends of a research fellow in charge of data collection (S.N.M.). The other authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Infectious Diseases, Infection Control and Employee Health, Unit 1460, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Sminil N. Mahajan MBBS, MPH, Ella J. Ariza-Heredia MD, Kenneth V. Rolston MD, Linda S. Graviss RN & Roy F. Chemaly MD, MPH, FIDSA, FACP

  2. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Barry W. Feig MD & Thomas A. Aloia MD, FACS

Authors
  1. Sminil N. Mahajan MBBS, MPH
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  2. Ella J. Ariza-Heredia MD
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  3. Kenneth V. Rolston MD
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  4. Linda S. Graviss RN
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  5. Barry W. Feig MD
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  6. Thomas A. Aloia MD, FACS
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  7. Roy F. Chemaly MD, MPH, FIDSA, FACP
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Corresponding author

Correspondence to Roy F. Chemaly MD, MPH, FIDSA, FACP.

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Mahajan, S.N., Ariza-Heredia, E.J., Rolston, K.V. et al. Perioperative Antimicrobial Prophylaxis for Intra-abdominal Surgery in Patients with Cancer: A Retrospective Study Comparing Ertapenem and Nonertapenem Antibiotics. Ann Surg Oncol 21, 513–519 (2014). https://doi.org/10.1245/s10434-013-3294-x

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  • DOI: https://doi.org/10.1245/s10434-013-3294-x

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