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Topical antibiotics in the high-risk biliary surgical patient. A prospective, randomized study.

Abstract
This randomized, prospective study has evaluated the efficacy of topical antibiotics in preventing infective complications in patients undergoing high-risk biliary surgery. Sixty-nine patients who underwent bile duct exploration, choledochoenteric anastomosis, or cholecystectomy, either for acute cholecystitis or because they were older than 65 years of age, were randomized to the following three groups: Group I, topical antibiotics alone (22 patients); Group II, cefoxitin and topical antibiotics (24 patients); and Group III, penicillin, tobramycin, clindamycin, and topical antibiotics (23 patients). The incidence of infective complications was no different among the groups. There was one wound infection in each group, one episode of bacteremia in Group II, and no intraabdominal abscesses. This study has demonstrated that parenteral antibiotics administered prophylactically in the perioperative period offer no additional benefit over the use of effective topical antibiotics used intraoperatively in patients undergoing high-risk biliary surgery.
AuthorsM G Sarr, K J Parikh, H Sanfey, S L Minken, J L Cameron
JournalAmerican journal of surgery (Am J Surg) Vol. 155 Issue 2 Pg. 337-42 (Feb 1988) ISSN: 0002-9610 [Print] United States
PMID3277476 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • Penicillins
  • Clindamycin
  • Cefoxitin
  • Tobramycin
Topics
  • Aged
  • Anti-Bacterial Agents (therapeutic use)
  • Anti-Infective Agents, Local (therapeutic use)
  • Biliary Tract Surgical Procedures
  • Cefoxitin (therapeutic use)
  • Clindamycin (therapeutic use)
  • Clinical Trials as Topic
  • Female
  • Humans
  • Male
  • Middle Aged
  • Penicillins (therapeutic use)
  • Premedication
  • Prospective Studies
  • Random Allocation
  • Risk Factors
  • Surgical Wound Infection (prevention & control)
  • Tobramycin (therapeutic use)

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