Title:
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Oral Antibiotic Prophylaxis Lowers Surgical Site Infection in Elective Colorectal Surgery: Results of a Pragmatic Cohort Study in Catalonia
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Author:
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Badia, Josep M; Flores Yélamos, Míriam; Vázquez, Ana; Arroyo García, Nares; Puig Asensio, Mireia; Parés, David; Pera, Miguel; Lopez-Contreras, Joaquin; Limón, Enric; Pujol, Miquel
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Other authors:
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[Badia JM, Flores-Yelamos M, Arroyo-García N] Department of Surgery, Hospital General Granollers, Granollers, Spain. School of Medicine, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain. [Vázquez A] Servei d’Estadística Aplicada, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain. [Puig-Asensio M] Department of Infectious Diseases, Hospital Universitari de Bellvitge, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0005), L’Hospitalet del Llobregat, Spain. [Parés D] Department of Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. [Pera M] Department of Surgery, Hospital del Mar, Barcelona, Spain. [López-Contreras J] Infectious Disease Unit, Hospital de la Santa Creu i Sant Pau–Institut d’Investigació Biomèdica Sant Pau, Barcelona, Spain. [Limón E] VINCat Program, Barcelona, Spain. Universitat de Barcelona, Barcelona, Spain. [Pujol M] Department of Infectious Diseases, Hospital Universitari de Bellvitge, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0005), L’Hospitalet del Llobregat, Spain. VINCat Program, Barcelona, Spain; Hospital General de Granollers |
Abstract:
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Colorectal surgery; Mechanical bowel preparation; Oral antibiotic prophylaxis |
Abstract:
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Cirugía colorrectal; Preparación mecánica del intestino; Profilaxis antibiótica oral |
Abstract:
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Cirurgia colorrectal; Preparació mecànica de l'intestí; Profilaxi antibiòtica oral |
Abstract:
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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. |
Subject(s):
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-Infecció -Antibiòtics -Còlon - Cirurgia -DISCIPLINES AND OCCUPATIONS::Health Occupations::Medicine::Specialties, Surgical::Colorectal Surgery -DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications::Surgical Wound Infection -ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Drug Therapy::Therapeutics::Drug Therapy::Premedication::Antibiotic Prophylaxis -DISCIPLINAS Y OCUPACIONES::profesiones sanitarias::medicina::especialidades quirúrgicas::cirugía colorrectal -ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias::infección de la herida quirúrgica -TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::farmacoterapia::terapéutica::farmacoterapia::premedicación::profilaxis antibiótica |
Rights:
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Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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Document type:
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Article Article - Published version |
Published by:
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MDPI
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