The effect of perioperative use of antibiotics on clinical indicators of thoracic surgery: A case control study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIAO Hu , SONG Shangqi , PU Qiang , MEI Jiandong , XIAO Zhilan , XIA Liang ,  LIU Lunxu

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

LIU Lunxu, Email: lunxu_liu@aliyun.com

Keywords：

Prevention; surgery; antibiotics; thoracic surgery

DOI：

10.7507/1007-4848.201711065

Video：

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Objective To explore the effect of standardized use of antibiotics on clinical indicators after thoracic surgery, such as pulmonary infection rate, incision infection rate, average length of hospital stay and total hospitalization cost. Methods We selected 468 patients (an observation group) who were hospitalized and received thoracic surgery from August to October 2011, 3 months after the implementation of the preventive antibiotics use protocol for thoracic surgery in West China Hospital, Sichuan University, and selected 343 patients (a control group) in the same period of the previous year (from August to October 2010). There were 326 males and 142 females with a mean age of 52.0±15.5 years in the observation group, and 251 males and 92 females with a mean age of 51.4±15.9 years in the control group. The level of antibiotic use, medication time, antibiotics cost, postoperative incision infection, incidence of pulmonary infection, postoperative hospital stay and total hospitalization cost were compared between the two groups. Results Compared with the control group, the time for preventive use of antibiotics was significantly shorter in the observation group (3.6±2.4 d vs. 6.1±3.1 d, P=0.020) and the total cost of antibiotic use significantly reduced (1 230.0±2 151.0 yuan vs.2 252.0±1 764.0 yuan, P<0.001). There was no significant difference between the two groups in hospitalization cost(36 345.0±13 320.0 yuanvs. 35 821.0±11 991.0 yuan, P=0.566), postoperative hospital stay (10.6±8.4 d vs. 10.7±5.3 d, P=0.390), the incidence of postoperative wound infection or postoperative pulmonary infection (1.5% vs. 2.3%, P=0.430; 19.2% vs. 22.2%, P=0.330). Conclusion The standardized use of antibiotics in thoracic surgery does not cause postoperative pulmonary infection and incision infection, and has no negative impact on clinical indicators. Significantly reducing the level of antibiotics use may have a positive effect on reducing medication time, in-hospital infection and the incidence of drug-resistant strains.

Citation： LIAO Hu, SONG Shangqi, PU Qiang, MEI Jiandong, XIAO Zhilan, XIA Liang, LIU Lunxu. The effect of perioperative use of antibiotics on clinical indicators of thoracic surgery: A case control study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(5): 393-396. doi: 10.7507/1007-4848.201711065 Copy

1.	Zhang R, Eggleston K, Rotimi V, et al. Antibiotic resistance as a global threat: evidence from China, Kuwait and the United States. Global Health, 2006, 2: 6.
2.	Taubes G. The bacteria fight back. Science, 2008, 321(5887): 356-361.
3.	Kunin CM, Johansen KS, Worning AM, et al. Report of a symposium on use and abuse of antibiotics worldwide. Rev Infect Dis, 1990, 12(1): 12-19.
4.	Hvistendahl M. Public health. China takes aim at rampant antibiotic resistance. Science, 2012, 336(6083): 795.
5.	Bratzler DW, Houck PM, Surgical Infection Prevention Guideline Writers Workgroup. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Am J Surg, 2005, 189(4): 395-404.
6.	中华医学会外科学分会, 中华外科杂志编辑委员会. 围手术期预防使用抗菌药物指南. 中华外科杂志, 2006, 44(23): 1594-1596.
7.	何绥平, 黎沾良, 颜青. 围手术期预防应用抗菌药物调查分析. 中华外科杂志, 2008, 46(1): 12-14.
8.	陈刚, 肖朴, 花柱明, 等. 胸外科手术预防性应用抗生素的临床研究. 中华医院感染学杂志, 2003, 13(3): 266-268.
9.	姜丽岩, 何礼贤, 李善群, 等. 手术相关肺炎的高危因素. 上海医科大学学报, 2000, 27(5): 390-392.
10.	Swoboda SM, Merz C, Kostuik J, et al. Does intraoperative blood loss affect antibiotic serum and tissue concentrations? Arch Surg, 1996, 131(11): 1165-1171.
11.	崔少罡, 白玲, 常诚, 等. 剖胸术后切口感染经济损失病例对照分析. 中华医院感染学杂志, 2002, 12(2): 87-88.

1. Zhang R, Eggleston K, Rotimi V, et al. Antibiotic resistance as a global threat: evidence from China, Kuwait and the United States. Global Health, 2006, 2: 6.
2. Taubes G. The bacteria fight back. Science, 2008, 321(5887): 356-361.
3. Kunin CM, Johansen KS, Worning AM, et al. Report of a symposium on use and abuse of antibiotics worldwide. Rev Infect Dis, 1990, 12(1): 12-19.
4. Hvistendahl M. Public health. China takes aim at rampant antibiotic resistance. Science, 2012, 336(6083): 795.
5. Bratzler DW, Houck PM, Surgical Infection Prevention Guideline Writers Workgroup. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Am J Surg, 2005, 189(4): 395-404.
6. 中华医学会外科学分会, 中华外科杂志编辑委员会. 围手术期预防使用抗菌药物指南. 中华外科杂志, 2006, 44(23): 1594-1596.
7. 何绥平, 黎沾良, 颜青. 围手术期预防应用抗菌药物调查分析. 中华外科杂志, 2008, 46(1): 12-14.
8. 陈刚, 肖朴, 花柱明, 等. 胸外科手术预防性应用抗生素的临床研究. 中华医院感染学杂志, 2003, 13(3): 266-268.
9. 姜丽岩, 何礼贤, 李善群, 等. 手术相关肺炎的高危因素. 上海医科大学学报, 2000, 27(5): 390-392.
10. Swoboda SM, Merz C, Kostuik J, et al. Does intraoperative blood loss affect antibiotic serum and tissue concentrations? Arch Surg, 1996, 131(11): 1165-1171.
11. 崔少罡, 白玲, 常诚, 等. 剖胸术后切口感染经济损失病例对照分析. 中华医院感染学杂志, 2002, 12(2): 87-88.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The effect of perioperative use of antibiotics on clinical indicators of thoracic surgery: A case control study

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