title: Antibiotic prophylaxis in elective laparoscopic cholecystectomy is useless. A prospective multicenter study.
abstract: OBJECTIVE
  We performed a prospective study to evaluate the effect of antibiotic prophylaxis (AP) on the incidence of infection in elective laparoscopic cholecystectomy (LC).
  
  
  METHODS
  All patients were at low-medium anesthetic and infectious risk and underwent LC for benign disease. At induction of anesthesia 41 patients received ampicillin-sulbactam 3g, 40 patients received ciprofloxacin 400mg intravenously, and 53 patients received no AP.
  
  
  RESULTS
  Postoperative infection was observed in 11 patients (8.2%) in the entire study group. All ob served infections were superficial surgical site infections (SSIs), always located at the umbilical incision. Infection occurred in 3 patients (7.3%) in ampicillin-sulbactam group, in 3 patients (7.5%) in ciprofloxacin group and in 5 patients (9.4%) in nonantibiotic group (p=0.916). Univariate analysis showed that duration of operation, placement of a drain and postoperative hospital stay were significantly associated with the development of SSIs. At multivariate analysis, only duration of operation was statistically significant in predicting SSIs.
  
  
  CONCLUSIONS
  The present study did not show any advantage in the use of AP, although in case of difficult surgery the risk of SSIs is increased, in particular in the umbilical incision. In all patients, the bile culture was sterile, then the infection of the umbilical site is not due to bacterial infection from the gallbladder.
  
  
  CONCLUSIONS
  AP in elective LC should not be routinely performed. A particular attention to the preoperative cleaning and topical antibiotic therapy of the umbilical area is advised.
authors.forename: Erasmo
authors.initials: E
authors.lastname: Spaziani
authors.forename: Marcello
authors.initials: M
authors.lastname: Picchio
authors.forename: Annalisa
authors.initials: A
authors.lastname: Di Filippo
authors.forename: Ettore
authors.initials: E
authors.lastname: Greco
authors.forename: Alessandra
authors.initials: A
authors.lastname: Cerioli
authors.forename: Maurizio
authors.initials: M
authors.lastname: Maragoni
authors.forename: Giuliano
authors.initials: G
authors.lastname: Faccì
authors.forename: Pierino
authors.initials: P
authors.lastname: Lucarelli
authors.forename: Giusppe
authors.initials: G
authors.lastname: Marino
authors.forename: Franco
authors.initials: F
authors.lastname: Stagnitti
authors.forename: Piero
authors.initials: P
authors.lastname: Narilli
mesh_terms: D019072:Antibiotic Prophylaxis; D017081:Cholecystectomy, Laparoscopic; D017558:Elective Surgical Procedures; D006801:Humans; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*