title: Current practice of antibiotic prophylaxis during elective laparoscopic cholecystectomy.
abstract: INTRODUCTION Current guidelines do not recommend antibiotic prophylaxis in elective laparoscopic cholecystectomy. Despite this, there is wide variation in antibiotic prophylaxis during cholecystectomy in population-based studies. The aim of this survey was to establish the current rationale for antibiotic prophylaxis in elective laparoscopic cholecystectomy. METHODS A short questionnaire was designed and disseminated across collaborators for a population-based study investigating outcomes following cholecystectomy and via the Association of Upper Gastrointestinal Surgeons, Researchgate and Surginet membership. RESULTS Responses were received from 234 people; 50.9% had no written policy for the use of prophylactic antibiotics in elective cholecystectomy; 5.6% never used antibiotics, while 30.8% always did and 63.7% selectively used antibiotics. Contamination with bile, stones and pus were scenarios in which antibiotics were most commonly used in selective practices to reduce infective complications. Interestingly, 87% of respondents would be happy to participate in a trial investigating the effectiveness of antibiotics in elective laparoscopic cholecystectomy where contamination has occurred. CONCLUSIONS The disparity between current practice and guidelines appears to arise because of a lack of evidence to show that antibiotics reduce surgical site infection following elective laparoscopic cholecystectomy where contamination has occurred. This question needs to addressed before practice will change.
authors.affiliation: Department of Upper Gastrointestinal Surgery, University Hospitals of North Midlands, Stoke-on-Trent , Staffordshire , UK.
authors.forename: Caw
authors.initials: C
authors.lastname: Macano
authors.affiliation: Department of Upper Gastrointestinal Surgery, Queen Elizabeth Hospital, University Hospitals, Birmingham NHS Foundation Trust , Birmingham , UK.
authors.forename: E A
authors.initials: EA
authors.lastname: Griffiths
authors.affiliation: West Midlands Research Collaborative, University of Birmingham , Birmingham , UK.|Department of Oesophago-Gastric Surgery, Nottingham University Hospitals , Nottingham , UK.
authors.forename: R S
authors.initials: RS
authors.lastname: Vohra
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D017558:Elective Surgical Procedures / Q000379:methods; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic prophylaxis; Cholecystectomy; Elective surgical procedures; Laparoscopic