Oral Antibiotic Prophylaxis Lowers Surgical Site Infection in Elective Colorectal Surgery: Results of a Pragmatic Cohort Study in Catalonia
Por:
Badia, JM, Flores-Yelamos, M, Vazquez, A, Arroyo-Garcia, N, Puig-Asensio, M, Pares, D, Pera, M, Lopez-Contreras, J, Limon, E, Pujol, M
Publicada:
1 dic 2021
Resumen:
Background: The role of oral antibiotic prophylaxis (OAP) and mechanical bowel preparation (MBP) in the prevention of surgical site infection (SSI) after colorectal surgery is still controversial. The aim of this study was to analyze the effect of a bundle including both measures in a National Infection Surveillance Network in Catalonia. Methods: Pragmatic cohort study to assess the effect of OAP and MBP in reducing SSI rate in 65 hospitals, comparing baseline phase (BP: 2007-2015) with implementation phase (IP: 2016-2019). To compare the results, a logistic regression model was established. Results: Out of 34,421 colorectal operations, 5180 had SSIs (15.05%). Overall SSI rate decreased from 18.81% to 11.10% in BP and IP, respectively (OR 0.539, CI95 0.507-0.573, p < 0.0001). Information about bundle implementation was complete in 61.7% of cases. In a univariate analysis, OAP and MBP were independent factors in decreasing overall SSI, with OR 0.555, CI95 0.483-0.638, and OR 0.686, CI95 0.589-0.798, respectively; and similarly, organ/space SSI (O/S-SSI) (OR 0.592, CI95 0.494-0.710, and OR 0.771, CI95 0.630-0.944, respectively). However, only OAP retained its protective effect at both levels at multivariate analyses. Conclusions: oral antibiotic prophylaxis decreased the rates of SSI and O/S-SSI in a large series of elective colorectal surgery.
Filiaciones:
Badia, JM:
Hosp Gen Granollers, Dept Surg, Barcelona 08348, Spain
Univ Int Catalunya, Sch Med, Barcelona 08195, Spain
Flores-Yelamos, M:
Hosp Gen Granollers, Dept Surg, Barcelona 08348, Spain
Univ Int Catalunya, Sch Med, Barcelona 08195, Spain
Vazquez, A:
Univ Autonoma Barcelona, Serv Estadist Aplicada, Barcelona 08193, Spain
Arroyo-Garcia, N:
Hosp Gen Granollers, Dept Surg, Barcelona 08348, Spain
Univ Int Catalunya, Sch Med, Barcelona 08195, Spain
Puig-Asensio, M:
Hosp Univ Bellvitge, Spanish Network Res Infect Dis REIPI RD16 0016 00, Dept Infect Dis, Barcelona 08907, Spain
Pares, D:
Hosp Badalona Germans Trias & Pujol, Dept Surg, Barcelona 08916, Spain
Pera, M:
Hosp del Mar, Dept Surg, Barcelona 08003, Spain
Lopez-Contreras, J:
Hosp Santa Creu & Sant Pau, Infect Dis Unit, Inst Invest Biomed St Pau, Barcelona 08041, Spain
Limon, E:
VINCat Program, Barcelona 08028, Spain
Univ Barcelona, Barcelona 08007, Catalonia, Spain
Pujol, M:
Hosp Univ Bellvitge, Spanish Network Res Infect Dis REIPI RD16 0016 00, Dept Infect Dis, Barcelona 08907, Spain
VINCat Program, Barcelona 08028, Spain
gold, Green Published
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