title: Outcomes of antibiotic prophylaxis in acute cholecystectomy in a population-based gallstone surgery registry.
abstract: BACKGROUND
  The aim of this study was to assess the effect of antibiotic prophylaxis (AP) on postoperative infections in acute cholecystectomy.
  
  
  METHODS
  The study was based on acute cholecystectomies registered in the nationwide Swedish Register for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks) between 2006 and 2010. The association between AP and the risk of postoperative infectious complications was tested in a multivariable regression analysis, with stepwise addition of age, sex, duration of operation, indication for surgery, surgical approach (laparoscopic versus open) and American Society of Anesthesiologists (ASA) fitness grade as co-variables. Postoperative infections requiring antibiotic treatment and postoperative abscesses were defined as outcome measures.
  
  
  RESULTS
  AP was given to 9549 (68.6 per cent) of 13 911 patients. Postoperative infections requiring antibiotic treatment occurred following 1070 procedures (7.7 per cent), including 805 patients (8.4 per cent) who received AP (P < 0.001 versus patients without AP). Postoperative abscesses developed after 273 procedures (2.0 per cent), including 208 patients (2.2 per cent) who received AP (P = 0.007). In univariable analysis, the odds ratio for development of infectious complications necessitating treatment with antibiotics was 1.42 (95 per cent confidence interval 1.23 to 1.64) for those who received AP versus those who did not, and for postoperative abscesses it was 1.47 (1.11 to 1.95). In multivariable analysis, adjusting for confounders, the odds ratios were 0.93 (0.79 to 1.10) and 0.88 (0.64 to 1.21) respectively.
  
  
  CONCLUSIONS
  The present study suggests that AP provides no benefit in acute cholecystectomy.
authors: Division of Surgery, Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.
authors: G
authors: G
authors: Jaafar
authors: G
authors: G
authors: Persson
authors: B
authors: B
authors: Svennblad
authors: G
authors: G
authors: Sandblom
mesh_terms: D000038:Abscess / Q000517:prevention & control*; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D002763:Cholecystectomy / Q000009:adverse effects*; D005260:Female; D005704:Gallbladder / Q000293:injuries; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011182:Postoperative Care; D012042:Registries; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents