Variation of prophylactic antibiotic in laparoscopic cholecystectomy: Songklanagarind Hospital perspective.

OBJECTIVE Evaluate the effectiveness of variation of prophylactic antibiotic in laparoscopic cholecystectomy. MATERIAL AND METHOD A retrospective data review was undertaken of patients who received a laparoscopic cholecystectomy between January 1, 2005 and December 31, 2008 in Songklanagarind Hospital. The prevalence of surgical site infection (SSI), the variation of antibiotic prescription, and associated factors with SSI were reviewed and analyzed. RESULTS Four hundred thirty nine patients received a successful laparoscopic cholecystectomy. The prophylactic antibiotic was utilized in 328 patients (74.7%). Cefazolin was the most common antibiotic used. Only 3 patients (0.9%) received the antibiotic according to the recommendation of center for disease control and prevention (CDC). The SSI was accounted in 41 patients (9.3%); 29 had the prophylactic antibiotic, while 12 did not. There was no statistically significant difference in the prevalence of SSI between the two groups (p = 0.54). Factor significantly associated with SSI was the operative time more than three hours (p = 0.03). CONCLUSION Various patterns of prophylactic antibiotic were encountered. The practice variation seemed to be ineffective in the prevention of SSI. The selectively risk factors should be considered in the antibiotic prophylaxis.