Pierre Net1,2*, Yann Neuzillet3-6, Françoise Karnycheff2, Martine Butreau3, Barbara Szekely4, Marc Vasse5, Brigitte Bonan1 and Thierry Lebret3-6
1Department of Pharmacy, Hospital Foch, France
2Department of Infectious Disease Control, Hospital Foch, France
3Department of Urology, Hospital Foch, France
4Department of Anesthesia, Hospital Foch, France
5Department of Clinical Microbiology, Hospital Foch, France
6University of Versailles, Saint-Quentin-en-Yvelines, France
Objectives: To assess the impact of the 2010 update of the French guidelines for Antimicrobial Prophylaxis (ABP) in surgery on Surgical Site Infections (SSI) after nephrectomy. Methods: A retrospective monocentric study was conducted among patients who had a nephrectomy with ABP (years 2009-2010) and without ABP (years 2013-2014), regardless of the indication. Surgical site infection, based on the definition given by the French guidelines on the prevention of surgical site infections, was the main outcome. Operative time, ASA score and wound class according to the Altemeier classification were recorded and the NNIS (National Nosocomial Infection Surveillance) risk index was calculated for each patient. The other following parameters were also recorded: age, Arterial Hypertension (AHT), diabetes mellitus, smoking, immunosuppression, Body Mass Index (BMI) and Length of Stay (LoS). Results: A 218 and 253 patients had a nephrectomy in 2009-2010 and 2013-2014 respectively. SSI rates were 1.83% and 8.3% for 2009-2010 and 2013-2014 respectively (p<0.002). No statistical significance were observed concerning the following parameters: AHT, ASA score, smoking, immunosuppression, BMI, age, Altemeier wound class and LoS. Conclusion: We observed a statistical significant increase of SSI rates in nephrectomy since we stopped systematic ABP in 2011. Further studies are required to identify and rank every parameter that can affect SSI rates in nephrectomy in order to confirm or deny the interest of ABP in nephrectomies.
Antibiotic prophylaxis; Surgical site infection; Nephrectomy; Urologic surgery
Net P, Neuzillet Y, Karnycheff F, Butreau M, Szekely B, Vasse M, et al. Controversy in Antibiotic Prophylaxis during Nephrectomies: Retrospective Study about 471 Procedures. Clin Surg. 2019; 4: 2615.