The Value Of Using Prophylactic Antibiotics In Perioperative Period Of Gastrointestinal Tumor

Postoperative infection is a common complication after surgery. Using prophylactic antibiotic has become the most effective measure in controlling infection after the asepsis. Although adequate usage of prophylactic antibiotics could reduce complication after surgery and total hospital expenses, inadequate usage may increase the hospital expenses, and more importantly, screen out the resistant bacteria and increase the opportunity of superinfection. So how to use the antibiotics adequately during perioperative period and the timing of using antibiotics becomes an important study direction.Objective:Through the analysis and summary of the patients who received the gastrointestinal surgery in general surgery department of Huashan hospital, we study the value of using prophylactic antibiotics in perioperative period of gastrointestinal tumor, and discuss the timing of using antibiotics in perioperative period of gastrointestinal tumor.Materials and Methods:This is a retrospective study. Patients were selected from those who receive the gastrointestinal surgery in Huashan hospital between2012.5and2012.8. There are254patients chosen through a coherent selecting standard. Data were first divided into three sets:patients of upper gastrointestinal tract surgery, patients of lower gastrointestinal tract surgery and the total patients. Then the three sets were divided into fifteen groups:Group A includes patients receiving upper gastrointestinal surgery who were given antibiotics30min before operation and over two days after operation, Group B includes patients receiving upper gastrointestinal surgery who were given antibiotics30min before operation until two days after operation, Group C includes patients receiving upper gastrointestinal surgery who were given antibiotics over two days after operation, Group D includes patients receiving upper gastrointestinal surgery who were given antibiotics until two days after operation, Group E includes patients receiving upper gastrointestinal surgery who were given antibiotics30min before operation; Group F includes patients receiving lower gastrointestinal surgery who were given antibiotics30min before operation and over two days after operation, Group G includes patients receiving lower gastrointestinal surgery who were given antibiotics30min before operation until two days after operation, Group H includes patients receiving lower gastrointestinal surgery who were given antibiotics over two days after operation, Group I includes patients receiving lower gastrointestinal surgery who were given antibiotics until two days after operation, Group J includes patients receiving lower gastrointestinal surgery who were given antibiotics30min before operation; Group K includes patients receiving gastrointestinal surgery who were given antibiotics30min before operation and over two days after operation, Group L includes patients receiving gastrointestinal surgery who were given antibiotics30min before operation until two days after operation, Group M includes patients receiving gastrointestinal surgery who were given antibiotics over two days after operation, Group N includes patients receiving gastrointestinal surgery who were given antibiotics until two days after operation, Group O includes patients receiving gastrointestinal surgery who were given antibiotics30min before operation. We make a comparative study among the fifteen groups:patients who were given antibiotics30min before operation until two days after operation were compared with patients who were given antibiotics30min before operation and over two days after operation; patients who were given antibiotics two days after operation were compared with patients who were given antibiotics over two days after operation; patients who were given antibiotics30min before operation until two days after operation were compared with patients who were given antibiotics30min before operation. Data were collected by unified form in which we observed age, sex, time of the surgery, rate of infection, postoperative temperature, WBC, hospital expenses and the length of stay in hospital. Data were conducted using STATA11.0software. Measurement data were dealt with t-test. Enumeration data were dealt with X2test. An alpha of0.05was used to claim statistical significance.Result:All patients who received gastrointestinal surgery were given antibiotics in perioperative period to prevent infection. There are one case of anastomotic leakage, three cases of pneumonia, and five cases of abdominal infection in Group A. There are one case of anastomotic leakage, one case of urinary tract infection, three cases of pneumonia and five cases of abdominal infection in Group B. These two groups have no statistical significance in the rate of infection, postoperative temperature and WBC. There is one case of pneumonia in Group C and one case of urinary tract infection in Group D. These two groups have no statistical significance in the rate of infection, postoperative temperature and WBC. There are one case of anastomotic leakage, one case of urinary tract infection, three cases of pneumonia and five cases of abdominal infection in Group B. There are one case of urinary tract infection and six cases of abdominal infection in Group E. These two groups have no statistical significance in the rate of infection, postoperative temperature and WBC. There are three cases of anastomotic leakage, three cases of pneumonia, two cases of incisional infection and nine cases of abdominal infection in Group F. There are one case of anastomotic leakage, one case of urinary tract infection, and two cases of pneumonia, three cases of incisional infection and seven cases of abdominal infection in Group G These two groups have statistical significance in the rate of infection. There are one case of incisional infection, one case of abdominal infection and one case of pneumonia in Group H. There are one case of pneumonia and two cases of incisional infection in Group I. These two groups have no statistical significance in the rate of infection, postoperative temperature and WBC. There are one case of anastomotic leakage, one case of urinary tract infection, and two cases of pneumonia, three cases of incisional infection and seven cases of abdominal infection in Group G. There are four cases of incisional infection and eight cases of abdominal infection in Group J. These two groups have statistical significance in the rate of infection. There are four cases of anastomotic leakage, six cases of pneumonia, two cases of incisional infection and fourteen cases of abdominal infection in Group K. There are two cases of anastomotic leakage, two cases of urinary tract infection, and five cases of pneumonia, three cases of incisional infection and twelve cases of abdominal infection in Group L. These two groups have statistical significance in the rate of infection. There are one case of incisional infection, one case of abdominal infection and two cases of pneumonia in Group M. There are one case of pneumonia, one case of urinary tract infection and two cases of incisional infection in Group N. These two groups have no statistical significance in the rate of infection, postoperative temperature and WBC. There are two cases of anastomotic leakage, two cases of urinary tract infection, and five cases of pneumonia, three cases of incisional infection and twelve cases of abdominal infection in Group L. There are four cases of incisional infection, one case of urinary tract infection and fourteen cases of abdominal infection in Group O. These two groups have statistical significance in the rate of infection. There is no statistical significance in the hospital expenses and in the length of stay in hospital among all these groups.Conclusion:It is necessary to use prophylactic antibiotics in gastrointestinal surgery during perioperative period. Prophylactic antibiotics should be used30minutes before the surgery to the upper gastrointestinal tract surgery. It is not necessary to use antibiotics after the surgery. Prophylactic antibiotics should be used30minutes before the surgery and two days after the surgery to the lower gastrointestinal tract surgery. It is not necessary to use antibiotics over two days after the surgery, because it will only increase the risk of drug resistant. Prolonged time of using prophylactic antibiotics did not impact the hospital expenses and the length of stay in hospital. Now a part of the patients were given antibiotics inappropriately in perioperative period, which shows that many surgeons rely on antibiotics too much to reduce the rate of infection.