[Perioperative antibiotic prophylaxis in transperitoneal tumor nephrectomy: does it lower the rate of clinically significant postoperative infections?].
This monocentric prospective randomized study was designed to determine the efficacy of single-shot perioperative antibiotic prophylaxis with 1 g ceftriaxone i.v. in transperitoneal tumor nephrectomy. Eighty-three patients were randomized either into a prophylaxis or a control group: 39 patients received 1 g ceftriaxone i.v. 30 min preoperatively and 44 no study medication. Characteristics of the two groups showed no statistical differences. Postoperative overall infection rates were 7.7% and 27.3% (p=0.007), respectively. Postoperative assessment revealed overall 0 (0%)/7 (15.9%) wound infections, 0 (0%)/2 (4.5%) deep wound infections, 1 (2.6%)/2 (4.5%) pneumoniae, and 2 (5.2%)/3 (6.8%) significant urinary tract infections. In 4 (10.3%)/4 (9.1%) patients, postoperative antibiosis was started without detection of an infectious focus. Overall antibiotic treatment was carried out in 7 (17.9%)/12 (27.3%) patients postoperatively. Costs of antibiotic prophylaxis and/or treatment resulted in 23.60/30.10ZZZ;EUR per patient. Perioperative prophylaxis with 1 g ceftriaxone i.v. decreases postoperative infection rates. Although not all infections have to be treated with antibiotics, there are pharmacoeconomic advantages of such prophylaxis.
Steiner
T
T
Klinik und Poliklinik für Urologie der Friedrich-Schiller-Universität Jena. thomas.steiner@uni-jena.de
Traue
C
C
Schubert
J
J
D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002443:Ceftriaxone / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D018410:Pneumonia, Bacterial / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone