Obesity Surgery

, Volume 23, Issue 7, pp 911–919

Serum In Vivo and In Vitro Activity of Single Dose of Ertapenem in Surgical Obese Patients for Prevention of SSIs

  • Carlo de Werra
  • Rosa Di Micco
  • Vincenzo Pilone
  • Antonio Formato
  • Emma Montella
  • Antonietta Lambiase
  • Domenica Cerbone
  • Maria Rosaria Catania
  • Pietro Forestieri
Clinical Research

Abstract

Background

Despite progress made in the control of post-operative infections, the incidence of surgical site infections (SSIs) is still high. An improper perioperative antibiotic use can expose patients to the risk of resistant microorganisms, and, in surgical obese patients, the drug dosage and infusion time are critical points. The aim of our study was to evaluate the effectiveness of ertapenem in the prophylaxis of SSIs in obese patients undergoing general or bariatric surgery.

Methods

A total of 63 obese patients, candidates for several surgical interventions, were enrolled and divided into two groups. Patients received antibiotic prophylaxis before surgery: the case group received venous infusion of ertapenem; the control group received standard prophylaxis. Serum samples were tested for antimicrobial activity against Gram-positive and Gram-negative bacteria.

Results

After single-dose ertapenem in obese patients, we registered in vitro activity of sera against the growth of non-extended beta lactamase (ESBL)-producing Escherichia coli, Proteus mirabilis, Citrobacter freundii, Enterobacter cloacae, and non-ESBL-producing Klebsiella pneumoniae. Moreover, methicillin-sensitive Staphylococcus aureus and Streptococcus viridans were also inhibited. We found in vivo efficacy according to clinical monitoring: at the weekly and monthly follow-ups, one patient in the case group and six patients in the control group presented superficial incisional SSIs.

Conclusions

These preliminary results are suggestive of the efficacy of ertapenem in perioperative prophylaxis of SSIs in obese patients; however, they need to be confirmed by further investigations and more defined trials.

Keywords

Surgical site infections Antibiotics Ertapenem Obesity 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Carlo de Werra
    • 1
    • 4
  • Rosa Di Micco
    • 1
  • Vincenzo Pilone
    • 1
  • Antonio Formato
    • 1
  • Emma Montella
    • 2
    • 4
  • Antonietta Lambiase
    • 3
    • 4
  • Domenica Cerbone
    • 3
  • Maria Rosaria Catania
    • 3
    • 4
  • Pietro Forestieri
    • 1
  1. 1.Department of General, Geriatric, Oncologic Surgery and Advanced Technologies“Federico II” UniversityNaplesItaly
  2. 2.Department of Preventive Medical Sciences“Federico II” UniversityNaplesItaly
  3. 3.Department of Molecular Medicine and Health Biotechnology“Federico II” UniversityNaplesItaly
  4. 4.Nosocomial Infection Control Committee (CIO)“Federico II” University HospitalNaplesItaly

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