Role of antibiotic prophylaxis on surgical site infection prevention in a low-risk population undergoing laparoscopic cholecystectomy: A randomized controlled study

Ann Med Surg (Lond). 2022 May 18:78:103804. doi: 10.1016/j.amsu.2022.103804. eCollection 2022 Jun.

Abstract

Objective: To compare the incidence of surgical site infections (SSIs) in low-risk patients undergoing laparoscopic cholecystectomy (LC) with pre-operative antibiotics versus no pre-operative antibiotics administration.

Study design: Randomized controlled study.

Setting: Hepatobiliary department, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Pakistan, from Jul 1, 2018, to Jun 30, 2021.

Methods: This is a prospective, open-label, randomized study. Individuals scheduled for laparoscopic cholecystectomy who met the inclusion requirements were randomly assigned to two groups. Group A patients received pre-operative antibiotics (intravenous cefazolin 2-g), and group B patients were operated on without administration of pre-operative antibiotics. Post-operatively, patients were studied for the occurrence of SSIs for 30 days.

Results: The mean age of patients in group A was 40.6 + 5.2 years, while group B was 41.04 + 5.03. The male to female ratio was 1:3. Gender distribution showed female dominance in both groups, i.e., 78.74% in group A and 76.80% in group B. The incidence of SSI in group A was 3.98%, while in group B was 4.9% (p-value = 0.584). No statistical significance was found while comparing both groups' age, gender, operative duration, and hospital stay.

Conclusion: This study showed comparable results between both groups, and prophylactic antibiotics have no impact in preventing SSIs. In low-risk individuals undergoing laparoscopic cholecystectomy, the incidence of SSIs is quite low, and prophylactic antibiotics can be avoided.

Keywords: Antibiogram; Efficacy; Infection; Laparoscopy; Pathogens; Surgery.