The Comparison of Single-Dose and Extended-Dose Antimicrobial Prophylaxis for Preventing Surgical Site Infections After Curative Surgery for Gastric Adenocarcinoma

Abstract

Objectives: There is no consensus on the duration of antimicrobial prophylaxis (AMP) for prevention of surgical site infections (SSI) after curative gastrectomy for gastric adenocarcinoma and the data is limited. In this study, we aimed to compare the effect of single-dose and extended-dose AMP on SSI prevention. Methods: A total of 210 patients who underwent curative gastrectomy for gastric cancer included in the study. Patients who received a single dose of 1 g cefazolin 30 minutes before the surgical incision were determined as single-dose group and the patients who received 1 g cefazolin one time 30 minutes before the surgical incision and every 12 hours until the first postoperative day were determined as extended-dose group. Demographic characteristics, postoperative outcomes and the types and incidence of SSI were compared in two groups and risk factors for SSI development were analyzed. Results: There was no significant difference in the demographic characteristics and postoperative outcomes in both AMP groups in the general patient population and in the subgroups formed based on different clinicopathological and operative factors. There was no significant difference in the incidence of SSI between the two groups (23,4% and 26,7% p = 0,346). Age, diabetes mellitus, chronic obstructive pulmonary disease (COPD), operation time and operative approach were found to be independent risk factors for SSI development. Conclusion: In patients undergoing curative gastrectomy for gastric adenocarcinoma, it has been found that the use of extended-dose AMP has no effect on reducing the incidence of SSI and single-dose AMP is sufficient and safe.