Perioperative Antimicrobial Prophylaxis for Intra-abdominal Surgery in Patients with Cancer: A Retrospective Study Comparing Ertapenem and Nonertapenem Antibiotics
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- Mahajan, S.N., Ariza-Heredia, E.J., Rolston, K.V. et al. Ann Surg Oncol (2014) 21: 513. doi:10.1245/s10434-013-3294-x
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To evaluate the role of ertapenem versus other standard antibiotic prophylaxis in patients with cancer undergoing intra-abdominal surgery.
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.
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.
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.