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A prospective randomized study to assess the optimal duration of intravenous antimicrobial prophylaxis in elective gastric cancer surgery.

Abstract
The duration of antimicrobial prophylaxis in gastric cancer surgery is not yet established. This prospective randomized study was performed to confirm the noninferiority of single-dose versus multiple-dose antimicrobial prophylaxis in terms of the incidence of surgical-site infection in gastric cancer surgery. Three hundred twenty-five patients undergoing elective resection for gastric cancer were randomized to receive only single-dose cefazolin (1 g) during surgery (single-dose group) or an additional 5 doses every 12 hours postoperatively (multiple-dose group). The overall incidence of surgical-site infections was 9.1% in the single-dose group and 6.2% in the multiple-dose group [difference (95% confidence interval): -2.9% (-5.9%-0.0%)]. Multivariate logistic regression analysis identified blood loss, being overweight, and advanced age as significant independent risk factors for surgical-site infection. Single-dose antimicrobial prophylaxis seemed to be acceptable, and choosing multiple-dose prophylaxis may have little impact on the prevention of surgical-site infections in elective gastric cancer surgery.
AuthorsNorihiro Haga, Hideyuki Ishida, Toru Ishiguro, Kensuke Kumamoto, Keiichiro Ishibashi, Yoshitaka Tsuji, Tatsuya Miyazaki
JournalInternational surgery (Int Surg) 2012 Apr-Jun Vol. 97 Issue 2 Pg. 169-76 ISSN: 2520-2456 [Electronic] Italy
PMID23102084 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Anti-Bacterial Agents
  • Cefazolin
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents (therapeutic use)
  • Antibiotic Prophylaxis (methods)
  • Cefazolin (therapeutic use)
  • Drug Administration Schedule
  • Elective Surgical Procedures
  • Female
  • Follow-Up Studies
  • Gastrectomy
  • Humans
  • Incidence
  • Intraoperative Care (methods)
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Postoperative Care (methods)
  • Prospective Studies
  • Risk Factors
  • Stomach Neoplasms (surgery)
  • Surgical Wound Infection (epidemiology, etiology, prevention & control)
  • Treatment Outcome

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