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Perioperative prophylaxis with piperacillin-tazobactam reduces complications following open pancreatoduodenectomy: JAMA

Written By : Aditi |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-05-15T10:00:23+05:30  |  Updated On 15 May 2023 2:13 PM IST
Perioperative prophylaxis with piperacillin-tazobactam reduces complications following open pancreatoduodenectomy: JAMA
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New York: Based on the recent findings from a study published in JAMA Network, piperacillin-tazobactam is effective as perioperative antimicrobial prophylaxis for reducing complications after open pancreatoduodenectomy. Compared to standard care, the percentage of patients with 30-day postoperative surgical site infection was reduced with broad-spectrum piperacillin-tazobactam.

Though perioperative mortality has improved, the incidence of SSI remains high after pancreatoduodenectomy. More data and research is required for the effect of broad-spectrum antimicrobial surgical prophylaxis in reducing SSI.

Are broad-spectrum antibiotics preoperatively reducing surgical site infection or SSI following open pancreatoduodenectomy more than standard care?

To investigate this, the researcher did the present study.

The following points explain the study summary:

  • Researchers included 456 men and 322 women of median age 67 years undergoing elective open pancreatoduodenectomy.
  • The study centres were located at 26 medical centres in US and Canada.
  • Nine hundred sixty-seven participants were randomized, and 778 were analyzed.
  • Three hundred seventy-eight participants were given Piperacillin-tazobactam 3.375 or 4.5 g intravenously within 60 min of incision and every 2-4 hours during operation until incision closure.
  • Four hundred participants were given Cefoxitin 2g intravenously within 60 min of incision and every 2-4 hours during operation until incision closure.
  • Surgical site infection or SSI within 30 days was the primary outcome measured in the study.
  • 75/378 patients constituting 19.8 %, were given Piperacillin-Tazobactam, and 131/400 patients constituting 32.8 %, were given Cefoxitin, had 30 days postoperative SSI with an absolute difference of -13% and an odds ratio of 0.51.

They said we found a reduced percentage of SSI at 30 days in the perioperative piperacillin-tazobactam vs cefoxitin group. Those treated with piperacillin-tazobactam had lower rates of postoperative sepsis and clinically relevant postoperative pancreatic fistula.

Mortality rates at 30 days were 1.3% among those treated with piperacillin-tazobactam and 2.5% among those receiving Cefoxitin.

Overall, the study supports using piperacillin-tazobactam as perioperative prophylaxis in open pancreatoduodenectomy.

Further reading:

D’Angelica MI, Ellis RJ, Liu JB, et al. Piperacillin-Tazobactam Compared With Cefoxitin as Antimicrobial Prophylaxis for Pancreatoduodenectomy: A Randomized Clinical Trial. JAMA. 2023;329(18):1579–1588. doi:10.1001/jama.2023.5728

Piperacillin-TazobactamPancreatoduodenectomysurgical site infectionSSIJAMA Network
Source : JAMA Network Open
Aditi
Aditi

    BDS, MDS in Periodontics and Implantology

    Dr. Aditi Yadav is a BDS, MDS in Periodontics and Implantology. She has a clinical experience of 5 years as a laser dental surgeon. She also has a Diploma in clinical research and pharmacovigilance and is a Certified data scientist. She is currently working as a content developer in e-health services. Dr. Yadav has a keen interest in Medical Journalism and is actively involved in Medical Research writing.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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