Antibiotics following gall bladder surgery do not appear to lower risk of infection

Patients who undergo gall bladder surgery do not appear to have a reduced risk of infection with the administration of antibiotics following the procedure, according to a new study.

A lack of postoperative antibiotic treatment following gall bladder removal for acute calculous cholecystitis did not appear to reduce the incidence of infections.

Guidelines published by the World Society of Emergency Surgery and the Infectious Diseases Society of America suggest treating gall bladder surgery patients with amoxicillin plus clavulanic acid or sulbactam for noncomplicated acute calculous cholecystitis.

Lead author Jean Marc Regimbeau, M.D., Ph.D., of the Amiens University Medical Center, Amiens, France and colleagues analyzed 414 patients suffering from mild to moderate acute calculous cholecystitis who either were prescribed a preoperative antibiotic regimen or no antibiotics at all following the procedure.

The researchers discovered that the rate of infections after gall bladder surgery was 17 percent among the non treatment group, compared to 15 percent in the antibiotic group. The lack of a postoperative antibiotic treatment was not found to be linked to a more adverse outcome as compared to antibiotic treatment.

“Supposing that these patients did not really need postoperative antibiotics (which are generally prescribed for 5 days), we estimate that many days of antibiotic treatment could be avoided each year. Reduction of the use of unnecessary antibiotics is important given that there is an increasing antibiotic resistance and a higher incidence of antibiotic complications such as Clostridium difficile infection. Our study demonstrates that postoperative antibiotics following acute calculous cholecystitis are not necessary,” Regimbeau said in a statement.