title: Prevention of early-onset pneumonia in surgical patients by chemoprophylaxis.
abstract: BACKGROUND
  The purpose of this study was to explore the impact of surgical antimicrobial chemoprophylaxis on the prevention of early-onset postsurgical pneumonia (EOPP) using a logistic regression model that included the principal risk or confusion factors associated with incidence of early-onset postsurgical pneumonia.
  
  
  METHODS
  The sample chosen corresponded to 13 years during which the epidemiological surveillance system was in place in the general and digestive surgery department (N = 13,024 patients) and was designed as a prospective cohort study. Risk factors associated with EOPP development were analyzed using a cohort-nested case-control study.
  
  
  RESULTS
  Cumulative incidence of EOPP in this series of patients was .6%, accounting for 24.7% of total nosocomial pneumonias. The multivariate model showed the following risks or confusion factors for EOPP: age, emergency admission, type of surgery, duration of surgical intervention, infection on admission, and antimicrobial chemoprophylaxis (administered, odds ratio = .18; 95% confidence interval, .09-.33).
  
  
  CONCLUSIONS
  Surgical antimicrobial chemoprophylaxis was associated as an independent factor with incidence reduction of early-onset postsurgical pneumonia, and, aside from its known effect on surgical site infection, its administration, where indicated, is useful for the prevention of early-onset postsurgical pneumonia.
authors.affiliation: Hospital Universitario La Paz and Facultad de Medicina de Universidad Autonoma de Madrid, Spain.
authors.forename: Jesus
authors.initials: J
authors.lastname: Diez-Sebastian
authors.forename: Rafael
authors.initials: R
authors.lastname: Herruzo
authors.forename: Juan
authors.initials: J
authors.lastname: Garcia-Caballero
mesh_terms: D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D016022:Case-Control Studies; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D011322:Primary Prevention / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D013997:Time Factors