Prolonged antibiotic prophylaxis after thoracoabdominal esophagectomy does not reduce the risk of pneumonia in the first 30 days: a retrospective before-and-after analysis

• DOI: 10.1007/s15010-018-1160-2
• Publication Date: 2018-06-05T05:25:19Z
• Authors: Marcel Hochreiter; Maria Uhling; Leila Sisic; Thomas Bruckner; Alexandra Heininger; Andreas Hohn; Katja Ott; Thomas Schmidt; Marc Moritz Berger; Daniel Christoph ...; Markus Büchler; Markus Alexander ...; Cornelius Johanne...
• Keywords: Male; Postoperative Care; Incidence; 610; Anastomotic Leak; Comorbidity; Pneumonia; ddc:no; Antibiotic Prophylaxis; Risk Assessment; 3. Good health; Esophagectomy; Patient Outcome Assessment; 03 medical and health sciences; Postoperative Complications; 0302 clinical medicine; Risk Factors; Humans; Surgical Wound Infection; Female; Mortality; Biomarkers; Retrospective Studies

Thoracoabdominal esophageal resection for malignant disease is frequently associated with pulmonary infection. Whether prolonged antibiotic prophylaxis beyond a single perioperative dose is advantageous in preventing pulmonary infection after thoracoabdominal esophagectomy remains unclear.In this retrospective before-and-after analysis, 173 patients between January 2009 and December 2014 from a prospectively maintained database were included. We evaluated the effect of a 5-day postoperative course of moxifloxacin, which is a frequently used antimicrobial agent for pneumonia, on the incidence of pulmonary infection and mortality after thoracoabdominal esophagectomy.104 patients received only perioperative antimicrobial prophylaxis (control group) and 69 additionally received a 5-day postoperative antibiotic therapy with moxifloxacin (prolonged-course). 22 (12.7%) of all patients developed pneumonia within the first 30 days after surgery. No statistically significant differences were seen between the prolonged group and control group in terms of pneumonia after 7 (p = 0.169) or 30 days (p = 0.133), detected bacterial species (all p > 0.291) and 30-day mortality (5.8 vs 10.6%, p = 0.274).A preemptive 5-day postoperative course of moxifloxacin does not reduce the incidence of pulmonary infection and does not improve mortality after thoracoabdominal esophagectomy.