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Risk factors for surgical site infection after pancreatic surgery: a better postoperative antibiotic strategy is possible
- Source :
- Journal of Hospital Infection, Journal of Hospital Infection, WB Saunders, 2021, 107, pp.28-34. ⟨10.1016/j.jhin.2020.09.023⟩
- Publication Year :
- 2021
- Publisher :
- HAL CCSD, 2021.
-
Abstract
- International audience; Introduction: Pancreatic surgery is associated with high morbidity, mainly due to infectious complications, so many centres use postoperative antibiotics (ATBpo) for all patients. However, antibiotic regimens vary according to local practices. The aims of this study were to describe the occurrence of surgical site infection (SSI) and ATBpo prescription after pancreatic surgery, and to determine the risk factors of postoperative SSI, in order to better define the clinical indications for ATBpo in this context.Patients and methods: All patients undergoing scheduled major pancreatic surgery from January 2007 to November 2018 were included in this retrospective study. Patients were classified into four groups according to SSI and routine ATBpo prescription: SSI+/ATBpo+, SSI-/ATBpo+, SSI+/ATBpo- and SSI-/ATBpo-. In addition, risk factors (fever and pre-operative biliary prosthesis) associated with the occurrence of SSI and ATBpo were analysed using a logistic regression model.Results: Data from 149 patients (115 pancreaticoduodenectomies and 34 splenopancreatectomies) were analysed. Thirty (20.1%) patients experienced SSI and 42 (28.2%) received ATBpo. No difference was found in routine ATBpo prescription between patients with and without SSI (26.7% vs 28.6%, respectively; P=0.9). Amongst the 107 patients who did not receive routine ATBpo, 85 (79.4%) did not develop an SSI. In-hospital mortality did not differ between infected and uninfected patients (7% vs 2%, respectively; P=0.13). The occurrence of postoperative fever differed between SSI+ and SSI- patients (73.3% vs 34.2%, respectively; P
- Subjects :
- Microbiology (medical)
medicine.medical_specialty
medicine.drug_class
medicine.medical_treatment
[SDV]Life Sciences [q-bio]
Antibiotics
Context (language use)
030501 epidemiology
Antimicrobial stewardship
Prosthesis
Pancreaticoduodenectomy
03 medical and health sciences
Postoperative fever
Major pancreatic surgery
Risk Factors
Internal medicine
Humans
Surgical Wound Infection
Medicine
Medical prescription
Pancreas
Digestive System Surgical Procedures
Retrospective Studies
0303 health sciences
030306 microbiology
business.industry
Retrospective cohort study
General Medicine
Antibiotic Prophylaxis
medicine.disease
Anti-Bacterial Agents
3. Good health
[SDV] Life Sciences [q-bio]
Infectious Diseases
Postoperative antibiotics
0305 other medical science
business
Surgical site infection
Subjects
Details
- Language :
- English
- ISSN :
- 01956701 and 15322939
- Database :
- OpenAIRE
- Journal :
- Journal of Hospital Infection, Journal of Hospital Infection, WB Saunders, 2021, 107, pp.28-34. ⟨10.1016/j.jhin.2020.09.023⟩
- Accession number :
- edsair.doi.dedup.....0d330a8d74adcdb1d8c7194bfd0ceab3