Broad-spectrum antibiotics after cholecystectomy increased length of hospitalization

Prescription of broad-spectrum antibiotics after cholecystectomy significantly increased the patient’s length of hospital stay and the risk of acute kidney injury. At the same time, the chances of infection of a postoperative wound during the use of broad- and narrow-spectrum antibiotics turned out to be similar.

Prescribing broad-spectrum antibiotics after cholecystectomy for common bile duct stones significantly prolonged hospital stay compared with patients prescribed narrow-spectrum antibiotics, a study by researchers from The Ohio State University Wexner Medical Center, Emory University School of Medicine and the University of Miami found. In addition, the use of broad-spectrum antibacterial agents was a risk factor for the development of acute kidney injury. The study results were published in the journal JACS.

The analysis showed that among patients who received broad-spectrum antibiotics, the duration of treatment was slightly longer compared to those who were prescribed narrow-spectrum antibacterial drugs (6 and 4 days, respectively). However, the incidence of infections in the surgical area was similar (0.9 and 0.5%). There were no differences in the rate of readmission due to surgical site infections within a month after the intervention (1.1 and 1.2%).

Patients who received broad-spectrum antibiotics spent significantly longer in hospital. They were significantly more likely to have acute kidney injury (5 and 1.4%, respectively). Further analysis showed that the use of broad-spectrum antibacterial drugs was a risk factor for the development of acute kidney injury (adjusted risk ratio 2.8).

The researchers assessed data from patients who underwent cholecystectomy for choledocholithiasis or acute biliary pancreatitis associated with common bile duct stones between 2016 and 2019. The analysis included 891 patients. 461 people (51.7%) received broad-spectrum antibiotics. Narrow-spectrum antibacterial drugs were prescribed to 430 participants (48.3%). The researchers assessed the incidence of surgical wound infection, length of hospital stay, acute kidney injury, and readmission for surgical wound infection within a month after the procedure.

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