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Abstract
The value of selecting patients for antibiotic cover during biliary surgery by the
use of immediate gram stains of bile was determined in a nonrandomized prospective
study which compared two groups of patients. Group A consisted of 119 consecutive
patients in whom antibiotics were administered during operation according to the results
of immediate gram stains on bile. Group B included 101 patients, none of whom received
antibiotics. In Group A gentamicin was given for gram-negative bacteria, ampicillin
for gram-positive organisms, and no antibiotics were given if no bacteria were seen
on the gram stain. In Group A the incidence of wound sepsis was 7 percent, compared
with 22 percent in Group B (p < 0.005). Septicemia occured in 2 percent of Group A,
compared with 8 percent in Group B. It is concluded that immediate gram stains of
bile will provide a means of selecting patients requiring antibiotic cover during
biliary surgery; furthermore, this procedure is a practical way of reducing postoperative
sepsis while avoiding unnecessary antibiotic administration.
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Article info
Publication history
Accepted:
October 5,
1976
Footnotes
☆Presented at the Tripartite Meeting, Philadelphia, Pa., 1976.
Identification
Copyright
© 1977 Published by Elsevier Inc.
