Cardiothoracic & vascular anesthesia
Antimicrobial Prophylaxis With Ampicillin-sulbactam Compared With Cefazolin for Esophagectomy: Nationwide Inpatient Database Study in Japan
Authors' conclusion
The administration of ABPC/SBT as antimicrobial prophylaxis for esophagectomy was associated with better short-term postoperative outcomes compared with CEZ.
Study context
- Population
- Patients undergoing esophagectomy for cancer, Japan, July 2010–March 2019
- Participants
- 17,772 eligible patients
- Exposure
- Ampicillin-sulbactam vs cefazolin antimicrobial prophylaxis
- ABPC/SBTn = 1,695
- CEZn = 16,077reference
- Outcome
- Short-term outcomes: SSI, anastomotic leakage, respiratory failure
Methodological detailsnationwide Japanese inpatient database, overlap propensity score weighting, sensitivity analyses: propensity score matching and instrumental variable analyses
- Nationwide Japanese inpatient database
- Overlap propensity score weighting
- Sensitivity analyses: propensity score matching and instrumental variable analyses
Main finding
As reported in the abstract
SSI, anastomotic leakage, respiratory failure
ABPC/SBT vs CEZOdds ratio (95% CI)
SSI
0.51(0.43–0.60)
Anastomotic leakage
0.51(0.43–0.61)
Respiratory failure
0.66(0.57–0.77)
- Surgical site infection (SSI) overall
- 2971 (16.7%)
- Anastomotic leakage overall
- 2604 (14.7%)
- Respiratory failure overall
- 2754 patients (15.5%)
Observational data: associations, not effects.
Further findings
- ABPC/SBT associated with reduced respiratory complications, postoperative LOS and total hospitalization costs
Safety
Clostridioides difficile colitis and noninfectious complications
- Proportion did not differ between the groups
Original publication
Antimicrobial Prophylaxis With Ampicillin-sulbactam Compared With Cefazolin for Esophagectomy: Nationwide Inpatient Database Study in Japan. Ann Surg. Published 15 December 2023. doi:10.
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