Variation of Prophylactic Antibiotic in Laparoscopic
Cholecystectomy: Songklanagarind Hospital Perspective
Sakchai Ruangsin MD*,
Thunchanok Wanasuwannakul MD**
Affiliation :
* Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
** Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
Objective : Evaluate the effectiveness of variation of prophylactic antibiotic in laparoscopic cholecystectomy.
Material and Method: A retrospective data review was undertaken of patients who received a laparoscopic cholecystectomy
between January 1, 2005 and December 31, 2008 in Songklanagarind Hospital. The prevalence of surgical site infection
(SSI), the variation of antibiotic prescription, and associated factors with SSI were reviewed and analyzed.
Results : Four hundred thirty nine patients received a successful laparoscopic cholecystectomy. The prophylactic antibiotic
was utilized in 328 patients (74.7%). Cefazolin was the most common antibiotic used. Only 3 patients (0.9%) received the
antibiotic according to the recommendation of center for disease control and prevention (CDC). The SSI was accounted in
41 patients (9.3%); 29 had the prophylactic antibiotic, while 12 did not. There was no statistically significant difference in
the prevalence of SSI between the two groups (p = 0.54). Factor significantly associated with SSI was the operative time more
than three hours (p = 0.03).
Conclusion : Various patterns of prophylactic antibiotic were encountered. The practice variation seemed to be ineffective in
the prevention of SSI. The selectively risk factors should be considered in the antibiotic prophylaxis.
Keywords : Laparoscopic cholecystectomy, Prophylactic antibiotic, Surgical site infection
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