Surgical Site Infection in Colorectal Surgery: A Study in Antibiotic Duration. Issue 9 (September 2017)

• Record Type: Journal Article
• Authors: Dornfeld, Mark; Lovely, Jenna K.; Huebner, Marianne; Larson, David W.
• Is Part Of: Diseases of the colon & rectum. Volume 60:Issue 9(2017)
• Publication Date: 2017-09
• Subjects: Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; Colonic Diseases -- Periodicals; Colorectal Surgery -- Periodicals; 616.34
• DOI: 10.1097/DCR.0000000000000807
• Languages: English
• ISSNs: 0012-3706

Abstract

Abstract : BACKGROUND: Despite distant historical studies that demonstrated the adequacy of preoperative antibiotic prophylaxis, current surgical practice continues to use antibiotics for postoperative coverage up to 24 hours. OBJECTIVE: The aim of this study was to evaluate a change in antibiotic prophylaxis duration and its effect on surgical site infection in a high-volume modern colorectal practice. DESIGN: A case-controlled series retrospectively reviewed outcomes through a prospective validated data base. SETTING: The study was conducted at Mayo Clinic, Rochester, Minnesota. PATIENTS: A total of 965 patients were evaluated. Our study analyzed patient outcomes related to surgical site infection comparing cohort 1 (2012–2013), which had the same antibiotic coverage preoperatively up to 24 hours postoperatively, and cohort 2 (2014–2015), which eliminated postoperative doses and relied solely on pre- and intraoperative dosing duration. MAIN OUTCOME MEASURES: The primary outcomes of this study are superficial and deep surgical site infection. RESULTS: There were no differences identified for superficial or deep surgical site infection rates between cohorts. Before the change in antibiotic dosing duration (2012–2013), 28 of 493 patients (5.7%) vs after the practice change (2014–2015), 25 of 472 patients (5.3%) were reported to have superficial or deep surgical site infection ( p = 0.794). LIMITATIONS: This study is limited by its retrospective design within a single institution. CONCLUSION: These equivalent results present an opportunity for surgeons to reconsider optimal antibiotic duration and minimize unnecessary antibiotic dosing.See Video Abstract athttp://links.lww.com/DCR/A322 . Abstract : Supplemental Digital Content is available in the text.