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Prolonged antibiotic prophylaxis after thoracoabdominal esophagectomy does not reduce the risk of pneumonia in the first 30 days: a retrospective before-and-after analysis

Purpose: Thoracoabdominal esophageal resection for malignant disease is frequently associated with pulmonary infection. Whether prolonged antibiotic prophylaxis beyond a single perioperative dose is advantageous in preventing pulmonary infection after thoracoabdominal esophagectomy remains unclear....

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Main Authors: Hochreiter, Marcel (Author) , Uhling, Maria (Author) , Peters, Leila (Author) , Bruckner, Thomas (Author) , Heininger, Alexandra (Author) , Schmidt, Thomas (Author) , Berger, Marc Moritz (Author) , Richter, Daniel (Author) , Büchler, Markus W. (Author) , Weigand, Markus A. (Author) , Busch, Cornelius (Author)
Format: Article (Journal)
Language:English
Published: 05 June 2018
In: Infection
Year: 2018, Volume: 46, Issue: 5, Pages: 617-624
ISSN:1439-0973
DOI:10.1007/s15010-018-1160-2
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/s15010-018-1160-2
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Author Notes:Marcel Hochreiter, Maria Uhling, Leila Sisic, Thomas Bruckner, Alexandra Heininger, Andreas Hohn, Katja Ott, Thomas Schmidt, Marc Moritz Berger, Daniel Christoph Richter, Markus Büchler, Markus Alexander Weigand, Cornelius Johannes Busch
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Summary:Purpose: Thoracoabdominal esophageal resection for malignant disease is frequently associated with pulmonary infection. Whether prolonged antibiotic prophylaxis beyond a single perioperative dose is advantageous in preventing pulmonary infection after thoracoabdominal esophagectomy remains unclear. Methods: In this retrospective before-and-after analysis, 173 patients between January 2009 and December 2014 from a prospectively maintained database were included. We evaluated the effect of a 5-day postoperative course of moxifloxacin, which is a frequently used antimicrobial agent for pneumonia, on the incidence of pulmonary infection and mortality after thoracoabdominal esophagectomy. Results: 104 patients received only perioperative antimicrobial prophylaxis (control group) and 69 additionally received a 5-day postoperative antibiotic therapy with moxifloxacin (prolonged-course). 22 (12.7%) of all patients developed pneumonia within the first 30 days after surgery. No statistically significant differences were seen between the prolonged group and control group in terms of pneumonia after 7 (p = 0.169) or 30 days (p = 0.133), detected bacterial species (all p > 0.291) and 30-day mortality (5.8 vs 10.6%, p = 0.274). Conclusion: A preemptive 5-day postoperative course of moxifloxacin does not reduce the incidence of pulmonary infection and does not improve mortality after thoracoabdominal esophagectomy.
Item Description:Gesehen am 06.03.2020
Physical Description:Online Resource
ISSN:1439-0973
DOI:10.1007/s15010-018-1160-2

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