Evaluation of postoperative antibiotic prophylaxis after liver resection: a randomized controlled trial

Am J Surg. 2013 Jul;206(1):8-15. doi: 10.1016/j.amjsurg.2012.08.016. Epub 2013 May 22.

Abstract

Background: Antibiotic prophylaxis is frequently administered after liver resection to prevent postoperative infections. However, very few studies have examined the usefulness of antibiotic prophylaxis after liver resection. A randomized controlled trial was conducted to evaluate the postoperative antibiotic prophylaxis in patients after liver resection.

Methods: A total of 241 patients scheduled to undergo liver resection were randomly assigned to the non-postoperative antibiotic group (n = 95) or the antibiotic group (n = 95). The antibiotic group was given flomoxef sodium every 12 hours for 3 days after the operation. The end point was signs of infection, surgical site infection, or infectious complications.

Results: There were no significant differences between the 2 groups in signs of infection (21.3% vs 25.5%, P = .606), the incidence of systemic inflammatory response syndrome (11.7% vs 17.0%, P = .406), infectious complications (7.5% vs 17.0%, P = .073), surgical site infection (10.6% vs 13.8%, P = .657), and remote site infection (2.1% vs 8.5%, P = .100).

Conclusions: Postoperative antibiotic prophylaxis cannot prevent postoperative infections after liver resection, and it is thought that antibiotic prophylaxis is unnecessary and costly.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotic Prophylaxis* / economics
  • Antibiotic Prophylaxis* / methods
  • Biomarkers / blood
  • Carcinoma, Hepatocellular / surgery
  • Cephalosporins / therapeutic use*
  • Cholangiocarcinoma / surgery
  • Female
  • Hepatectomy / adverse effects*
  • Hepatectomy / methods
  • Humans
  • Infections / etiology*
  • Infections / microbiology
  • Liver Neoplasms / metabolism
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Liver Transplantation / adverse effects
  • Male
  • Middle Aged
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / prevention & control
  • Systemic Inflammatory Response Syndrome / etiology
  • Systemic Inflammatory Response Syndrome / prevention & control
  • Treatment Failure

Substances

  • Anti-Bacterial Agents
  • Biomarkers
  • Cephalosporins
  • flomoxef