Abstract
Background
In Japan, antimicrobial prophylaxis (AMP) is typically administered for 3 to 4 days postoperatively for clean-contaminated operations such as distal gastrectomy. This far exceeds the recommended 2h or less laid out by the Centers for Disease Control (CDC) guidelines for the prevention of surgical-site infections (SSIs), after a clean-contaminated operation.
Methods
Patients with gastric cancer, which was curable by distal gastrectomy with D2 lymphandectomy, were assigned to a multicenter phase II study. One gram of cefazolin within 3min of the first surgical incision and intraoperative supplements of g of cefazolin every h were administered. AMP was not administered after skin closure unless postoperative infection occurred. The occurrence of SSIs was monitored until postoperative day 30 as the primary endpoint of this study.
Results
In 56 patients, three SSIs (5.4%) and one remote site infection (1.8%) developed. No other postoperative infections were observed.
Conclusion
Our data indicate that the CDC guidelines regarding AMP may also be sufficient for patients undergoing clean-contaminated operations in Japan.
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References
AJ Mangram TC Horan ML Pearson LC Silver WR Jarvis (1999) ArticleTitleGuidelines for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee Infect Control Hosp Epidemiol 20 231–2 Occurrence Handle10.1086/501620
JW Alexander JE Fischer M Boyajian J Palmquist MJ Morris (1983) ArticleTitleThe influence of hair-removal methods on wound infections Arch Surg 118 347–52 Occurrence Handle1:STN:280:BiyC38ngtVE%3D Occurrence Handle6824435
InstitutionalAuthorNameJapanese Gastric Cancer Association (1998) ArticleTitleClassification of gastric carcinoma. 2nd English ed. Gastric Cancer 1 10–24 Occurrence Handle10.1007/PL00011681 Occurrence Handle11957040
National Nosocomial Infection Surveillance System. Atlanta: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention (CDC); 1999
N Shinagawa K Mashita S Iwai T Yokoyama H Takeyama (2000) ArticleTitleA questionnaire survey on the theory of postoperative infection prophylaxis Jpn J Gastroenterol Surg 33 1559–63
RL Nichols (1989) ArticleTitleAntibiotic prophylaxis in surgery J Chemother 1 170–8 Occurrence Handle1:STN:280:By%2BD3M7itFw%3D Occurrence Handle2677259
JM Bumpous JT Johnson (1995) ArticleTitleThe infected wound and its management Otolaryngol Clin North Am 28 987–1001 Occurrence Handle1:STN:280:BymC3Mjjt10%3D Occurrence Handle8559584
A Higgins J London S Charland E Ratzer J Clark W Haun et al. (1999) ArticleTitleProphylactic antibiotics for elective laparoscopic cholecystectomy: are they necessary? Arch Surg 134 611–4 Occurrence Handle1:STN:280:DyaK1M3psVaruw%3D%3D Occurrence Handle10367869
CP Page JM Bohnen JR Fletcher AT McManus JS Solomkin DH Wittmann (1993) ArticleTitleAntimicrobial prophylaxis for surgical wounds. Guidelines for clinical care Arch Surg 128 79–88 Occurrence Handle1:STN:280:ByyC3Mbis1Q%3D Occurrence Handle8418785
DC Classen RS Evans SL Pestotnik SD Horn RL Menlove JP Burke (1992) ArticleTitleThe timing of prophylactic administration of antibiotics and risk of surgical-wound infection N Engl J Med 326 281–6 Occurrence Handle1:STN:280:By2C3c%2FhsVQ%3D Occurrence Handle1728731
H Ohge Y Takesue T Yokoyama Y Murakami E Hiyama Y Yokoyama et al. (1999) ArticleTitleAn additional dose of cefazolin for intraoperative prophylaxis Surg Today 29 1233–6 Occurrence Handle1:CAS:528:DC%2BD3cXptlWruw%3D%3D Occurrence Handle10639702
S Harbarth MH Samore D Lichtenberg Y Carmeli (2000) ArticleTitleProlonged antibiotic prophylaxis after cardiovascular surgery and its effect on surgical site infections and antimicrobial resistance Circulation 101 2916–21 Occurrence Handle1:CAS:528:DC%2BD3cXkvFWlsbo%3D Occurrence Handle10869263
KJ Dobay DT Freier P Albear (1999) ArticleTitleThe absent role of prophylactic antibiotics in low-risk patients undergoing laparoscopic cholecystectomy Am Surg 65 226–8 Occurrence Handle1:STN:280:DyaK1M7ntlKiuw%3D%3D Occurrence Handle10075297
A Tocchi L Lepre G Costa G Liotta G Mazzoni F Maggiolini (2000) ArticleTitleThe need for antibiotic prophylaxis in elective laparoscopic cholecystectomy Arch Surg 135 67–70 Occurrence Handle1:STN:280:DC%2BD3c7gtVejtw%3D%3D Occurrence Handle10636350
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Presented at the 40th annual meeting of the American Society of Clinical Oncology, New Orleans, LA, June 5–8, 2004.
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Imamura, H., Furukawa, H., Iijima, S. et al. Multicenter phase II study of antimicrobial prophylaxis in low-risk patients undergoing distal gastrectomy for gastric cancer. Gastric Cancer 9, 32–35 (2006). https://doi.org/10.1007/s10120-005-0354-3
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DOI: https://doi.org/10.1007/s10120-005-0354-3