SELECTING PATIENTS REQUIRING ANTIBIOTICS IN BILIARY SURGERY BY IMMEDIATE GRAM STAINS OF BILE AT OPERATION

  • 1 January 1977
    • journal article
    • research article
    • Vol. 81  (4) , 473-477
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 2 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%, compared with 22% in Group B (P < 0.005). Septicemia occurred in 2% of Group A, compared with 8% in Group B. Immediate gram stains of bile will provide a means of selecting patients requiring antibiotic cover during biliary surgery; this procedure is a practical way of reducing postoperative sepsis while avoiding unnecessary antibiotic administration.

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