J Gastric Cancer.  2010 Dec;10(4):206-211.

The Feasibility of Short Term Prophylactic Antibiotics in Gastric Cancer Surgery

• Lee JS
• Lee HH
• Song KY
• Park CH
• Jeon HM

Abstract

PURPOSE
Most surgeons administer prophylactic antibiotics for 3 to 5 days postoperatively. However, the Center for Disease Control (CDC) guideline recommends antibiotic therapy for 24 hours or less in clean/uncontaminated surgery. Thus, we prospectively studied the use of short term prophylactic antibiotic therapy after gastric cancer surgery.
MATERIALS AND METHODS
A total of 103 patients who underwent gastric cancer surgery between October 2007 and June 2008 were prospectively enrolled in a short term prophylactic antibiotics program. One gram of cefoxitin was administered 30 minutes before the incision, and one additional gram was administered intraoperatively for cases with an operation time over 3 hours. Postoperatively, one gram was administered 3 times, every 8 hours. Patients were checked routinely for fever. All cases received open surgery, and the surgical wounds were dressed and checked for Surgical Site Infection (SSI) daily.
RESULTS
Of the 103 patients, 15 were dropped based on exclusion criteria (severe organ dysfunction, combined resection of the colon, etc). The remaining 88 patients were included in the short-term program of prophylactic antibiotic use. Of these patients, SSIs were detected in 8 (9.1%) and fever after 2 postoperative days was detected in 11 (12.5%). The incidence of SSIs increased with patient age, and postoperative fever correlated with operation time.
CONCLUSIONS
Short term prophylactic antibiotic usage is feasible in patients who undergo gastric cancer surgery, and where there are no grave comorbidities or combined resection.

Keyword

Stomach neoplasm; Antibiotic prophylaxis; Anti-bacterial agents

MeSH Terms

Anti-Bacterial Agents
Antibiotic Prophylaxis
Cefoxitin
Centers for Disease Control and Prevention (U.S.)
Colon
Comorbidity
Fever
Humans
Incidence
Prospective Studies
Stomach Neoplasms
Anti-Bacterial Agents
Cefoxitin

Figure

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  Fig. 1 Inclusion criteria and exclusion critera. 103 patients had curative gastrectomy performed. 15 patients were excluded and 88 patients were chosen. 11 patients had antibiotics therapy restarted after the initial 24 hours. 78 patients did not need additional antibiotics therapy until discharge.

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