title: Effectiveness of antibiotic prophylaxis in cholecystectomy: a prospective population-based study of 1171 cholecystectomies.
abstract: BACKGROUND
  The aim of this study was to assess the benefit from antibiotic prophylaxis (AP) during cholecystectomy in a population-based cohort study.
  
  
  METHODS
  All cholecystectomies performed in Uppsala County, 2003-2005, were registered prospectively according to a standardized protocol. High-risk procedures (HP) were defined as operations for acute cholecystitis and procedures including exploration of the common bile duct. Infections requiring surgical or percutaneous drainage and non-surgical infections that prolonged hospital stay were defined as major infectious complications (IC).
  
  
  RESULTS
  Altogether 1171 patients underwent cholecystectomy. AP was given to 130 of 867 (15%) of the patients undergoing low-risk procedures (LP) and 205 of 304 (67%) of those undergoing H-R P. Major IC were seen in 6 of 205 (3%) of the patients undergoing H-R P with AP and 1 of 99 of the patients undergoing H-R P without AP. No major IC was seen after L-R P. Minor IC were seen after 5 of 205 (2%) HP with AP, 1 of 99 (1%) HP without AP, 0 of 130 (0%) LP with AP, and 2 of 737 (0.3%) LP without AP. In univariate logistic analysis, the overall risk for IC was found to be higher with AP (p < 0.05), but the increase did not remain significant if adjusting for age, gender, ASA class, H-R P/L-R P and surgical approach or limiting the analysis to major IC.
  
  
  CONCLUSIONS
  There is no benefit from AP in uncomplicated procedures. The effectiveness of antibiotic prophylaxis in complicated cholecystectomy must be evaluated in randomized controlled trials.
authors: Department of Surgery, Enköping Hospital, Enköping, Sweden. Bahman.Darkahi@lul.se
authors: Bahman
authors: B
authors: Darkahi
authors: Per
authors: P
authors: Videhult
authors: Gabriel
authors: G
authors: Sandblom
authors: Haakan
authors: H
authors: Liljeholm
authors: Mikael
authors: M
authors: Ljungdahl
authors: Ib Christian
authors: IC
authors: Rasmussen
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001424:Bacterial Infections / Q000145:classification / Q000209:etiology / Q000517:prevention & control*; D002763:Cholecystectomy / Q000009:adverse effects / Q000379:methods; D041881:Cholecystitis, Acute / Q000601:surgery*; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents