title: Selection of prophylactic antibiotics according to the microorganisms isolated from surgical site infections (SSIs) in a previous series of surgeries reduces SSI incidence after pancreaticoduodenectomy.
abstract: BACKGROUND
  The incidence of surgical site infections (SSIs) is high after pancreaticoduodenectomy (PD).
  
  
  METHODS
  We divided 116 consecutive patients who underwent PD into an early group (n = 58) and a later group (n = 58) according to time of surgery. In both groups, endoscopic retrograde biliary drainage was mainly employed for the patients with obstructive jaundice. In the later group, prophylactic antibiotics were selected according to the susceptibility of microorganisms isolated from SSIs in the early group. The incidence of SSIs was compared between the groups.
  
  
  RESULTS
  The background characteristics (including methods of preoperative biliary drainage and microorganisms in the bile obtained before or during operation) of the patients were not significantly different between the groups, except for the serum albumin level, which was lower in the later group than in the early group (P = 0.0026). The incidence of SSIs was significantly lower in the later group (24.1 %) than in the early group (46.6 %) (P = 0.0116). Belonging to the later group was one independent negative risk factor for SSI.
  
  
  CONCLUSIONS
  Selection of prophylactic antibiotics on the basis of microorganisms isolated from SSIs in the early group contributed to the reduced incidence of SSIs in the later group after PD.
authors.affiliation: Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kondo
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chijiiwa
authors.forename: Jiro
authors.initials: J
authors.lastname: Ohuchida
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kai
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Fujii
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Otani
authors.forename: Masahide
authors.initials: M
authors.lastname: Hiyoshi
authors.forename: Motoaki
authors.initials: M
authors.lastname: Nagano
authors.forename: Naoya
authors.initials: N
authors.lastname: Imamura
mesh_terms: D000368:Aged; D019072:Antibiotic Prophylaxis; D001650:Bile Duct Neoplasms / Q000601:surgery*; D016009:Chi-Square Distribution; D004322:Drainage / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D015994:Incidence; D041781:Jaundice, Obstructive / Q000601:surgery; D016015:Logistic Models; D008297:Male; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control*