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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2011, Número 6

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Rev Invest Clin 2011; 63 (6)


Profilaxis antimicrobiana perioperatoria en cirugía oncológica

Vilar-Compte D, García-Pasquel MJ

Idioma: Español
Referencias bibliográficas: 71
Paginas: 630-640
Archivo PDF: 165.27 Kb.


RESUMEN

La profilaxis antimicrobiana perioperatoria (PAP) es una medida eficaz para la prevención de las infecciones del sitio quirúrgico. Su utilidad está reconocida para todas las cirugías limpias-contaminadas y algunas cirugías limpias. Los antibióticos profilácticos están dirigidos a la cobertura de los gérmenes más frecuentes en el sitio operatorio; las cefalosporinas de primera y segunda generación son las más utilizadas. Para disminuir la curva de crecimiento bacteriano durante el procedimiento operatorio y garantizar niveles tisulares y séricos apropiados, es necesario administrar el antibiótico 20-60 min antes de la cirugía. Los antibióticos profilácticos no deben usarse por más de 24 h, ya que no ofrecen beneficios adicionales al paciente e incrementan los costos y la resistencia antimicrobiana. Los principios de la PAP en cirugía oncológica son los mismos que los descritos para el resto de la cirugía y se recomienda seguir los criterios estándares. En la cirugía limpia de cabeza y cuello, así como en las mastectomías, existen recomendaciones específicas que difieren de la cirugía no oncológica. En el caso de las cirugías muy extensas como las exenteraciones pélvicas o cirugías óseas con reconstrucciones amplias puede considerarse la extensión de los antibióticos por 48-72 h.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Bowater RJ, Stirling S, Lidford RJ. Is antibiotic prophylaxis in surgery a generally effective intervention? Testing a generic hypothesis over a set of meta-analysis. Ann Surg 2009; 249(4): 551-6.

  2. Bratzler DW, Houck PM. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Am J Surg 2005; 189(4): 395-404.

  3. Bratzler DW, Hunt DR. The surgical infection prevention and surgical care improvement projects: national initiatives to improve outcomes for patients having surgery. Clin Infect Dis 2006; 43(3): 322-30.

  4. Dellinger EP, Hausmann SM, Bratzler DW, Johnson RM, Daniel DM, Bunt KM, et al. Hospitals collaborate to decrease surgical site infections. Am J Surg 2005; 190(1): 9-15.

  5. Tan JA, Naik VN, Lingard L. Exploring obstacles to proper timing of prophylactic antibiotics for surgical site infections. Qual Saf Health Care 2006; 15(1): 32-8.

  6. Miliani K, L’Heriteau F, Astegneau P; INCISO Network Study Group. Non-compliance with recommendations for the preactice of antibiotic prophylaxis and risk of surgical site infections: results of a multilevel analysis from the INCISO Surveillance Network. J Antimicrob Chemother 2009; 64(6): 1307-15.

  7. Keegan MT, Brown DR. Perioperative antibiotics and practice: little things that make a big difference. Anesthesiol Clin North Am 2004; 22(3): 473-91.

  8. Weed HG. Antimicrobial prophylaxis in the surgical patient. Med Clin North Am 2003; 87(1): 59-75.

  9. Van Kasteren ME, Mannien J, Ott A, Kullberg BJ, de Boer AS, Gyssens IC. Antibiotic prophylaxis and the risk of surgical site infections following total hip arthroplasty: timely administration is the most important factor. Clin Infect Dis 2007; 44(7): 921-7.

  10. Dellinger EP. Prophylactic antibiotics: administration and timing before operation are more important than administration after operation. Clin Infect Dis 2007; 44(7): 928-30.

  11. Anderson DJ, Kaye KS, Classen D, Arias KM, Podgorny K, Burstin H, et al. Strategies to prevent surgical site infections in acute care hospitals. Infect Control Hosp Epidemiol 2008; 29(Suppl. 1): S51-S61.

  12. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999; 20(4): 250-78; quiz 279-80.

  13. Bratzler DW, Houck PM. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis 2004; 38(12): 1706-15.

  14. Weber W, Marti WR, Zwahlen M, Misteli H, Rosenthal R, Reck S, et al. The timing of surgical antimicrobial prophylaxis. Ann Surg 2008; 247(6): 918-26.

  15. Arriaga MA, Kanel KT, Johnson JT, Myers EN. Medical complications in total laryngectomy: incidence and risk factors. Ann Otol Rhinol Laryngol 1990; 99(8): 611-5.

  16. Simo R, F.G. The use of prophylactic antibiotics in head and neck oncological surgery. Curr Opin Otolaryngol Head Neck Surg 2006; 14(2): 55-61.

  17. Friberg D, Lundberg C. Antibiotic prophylaxis in major head and neck surgery when clean-contaminated wounds are established. Scand J Infect Dis Suppl 1990; 70: 87-90.

  18. Seven H, Sayin I, Turgut S. Antibiotic prophylaxis in clean neck dissections. J Laryngol Otol 2004; 118(3): 213-6.

  19. Carrau RL, BJ, Wagner RL, Johnson JT. Role of prophylactic antibiotics in uncontaminated neck dissections. Arch Otolaryngol Head Neck Surg 1991; 117(2): 194-5.

  20. Woods RK, Dellinger EP. Current guidelines for antibiotic prophylaxis of surgical wounds. Am Fam Physician 1998; 57(11): 2731-40.

  21. Lotfi CJ, Cavalcanti Rde., Costa e Silva AM, Latorre Mdo. R, Ribeiro Kde. C, Carvalho AL, et al. Risk factors for surgicalsite infections in head and neck cancer surgery. Otolaryngol Head Neck Surg 2008; 138(1): 74-80.

  22. Gerard M, Meunier F, Dor P, Andry G, Chantrain G, Van der Auwera P, et al. Antimicrobial prophylaxis for major head and neck surgery in cancer patients. Antimicrob Agents Chemother 1988; 32(10): 1557-9.

  23. Skitarelic N, Morovic M, Manestar D. Antibiotic prophylaxis in clean-contaminated head and neck oncological surgery. J Craniomaxillofac Surg 2007; 35(1): 15-20.

  24. Mohri Y. Tonouchi H, Kobayashi M, Nakai K, Kusunoki M. Randomized clinical trial of single- versus multiple-dose antimicrobial prophylaxis in gastric cancer surgery. Br J Surg 2007; 94(6): 683-8.

  25. Suehiro T, Hirashita T, Araki S, Matsumata T, Tsutsumi S, Mochiki, et al. Prolonged antibiotic prophylaxis longer than 24 hours does not decrease surgical site infection after elective gastric and colorectal surgery. Hepatogastroenterology 2008; 55(86-87): 1636-9.

  26. Kirby JP, Mazuski JE. Prevention of surgical site infections. Surg Clin North Am 2009; 89(2): 365-89.

  27. Fujita S, Saito N, Yamada T, Takii Y, Kondo K, Ohue M, et al. Randomized, multicenter trial of antibiotic prophylaxis in elective colorectal surgery: single dose vs. 3 doses of a secondgeneration cephalosporin without metronidazole and oral antibiotics. Arch Surg 2007; 142(7): 657-61.

  28. Rowe-Jones DC, Peel AL, Kingston RD, Shaw JF, Teasdale C, Cole DS. Single dose cefotaxime plus metronidazole versus three dose cefuroxime plus metronidazole as prophylaxis against wound infection in colorectal surgery: multicentre prospective randomized study. BMJ 1990; 300(6716): 18-22.

  29. Song F, Glenny AM. Antimicrobial prophylaxis in colorectal surgery: a systematic review of randomized controlled trials. Br J Surg 1998; 85(9): 1232-41.

  30. Nagy E, Urban E, Nord CE. Antimicrobial susceptibility of Bacteroides fragilis group isolates in Europe: 20 years of experience. Clin Microbiol Infect 2011; 17(3): 371-9.

  31. Snydman DR, Jacobus NV, McDermott LA, Golan Y, Hecht DW, Goldstein EJ, et al. Lessons learned from the anaerobe survey: historical perspective and review of the most recent data (2005-2007). Clin Infect Dis 2010; 50(Suppl. 1): S26-S33.

  32. Ishibashi K, Kuwabara K, Ishiguro T, Ohsawa T, Okada T, Miyazaki T, et al. Short-term intravenous antimicrobial prophylaxis in combination with preoperative oral antibiotics on surgical site infection and methicillin-resistant Staphylococcus aureus infection in elective colon cancer surgery: results of a prospective randomized trial. Surg Today 2009; 39(12): 1302-9.

  33. Suzuki T, Sadahiro S, Maeda Y, Tanaka A, Okada K, Kamijo A. Optimal duration of prophylactic antibiotic administration for elective colon cancer surgery: A randomized, clinical trial. Surgery

  34. Price SA, Polk HC Jr. Prophylactic and therapeutic use of antibiotics in pelvic surgery. J Surg Oncol 1999; 71(4): 261-8.

  35. Dicker RC, Greenspan JR, Strauss LT, Cowart MR, Scally MJ, Peterson HB, et al. Complications of abdominal and vaginal hysterectomy among women of reproductive age in the United States. The collaborative review of sterilization. Am J Obstet Gynecol 1982; 144(7): 841-8.

  36. Su HY, DingD, Chen DC, Lu MF, Liu JY, Chang FY. Prospective randomized comparison of single-dose versus 1-day cefazolin for prophylaxis in gynecologic surgery. Act Obstet Gynecol Scand 2005; 84(4); 84: 384-9.

  37. Hemsell DL. Prophylactic antibiotics in gynecologic and obstetric surgery. Rev Infect Dis 1991; 13(Suppl. 10): S821-S841.

  38. Ledger W. Prophylactic antibiotics in obstetrics-gynecology: a current asset, a future liability? Expert Rev Anti Infect Ther 2006; 4(6): 957-64.

  39. Mittendorf R, AronsonM, Berry RE, Williams MA, Kupelnick BA, Klickstein A, et al. Avoiding serious infections associated with abdominal histerectomy: A meta-analysis of antibiotic prophylaxis. Am J Obstet Gynecol 1993; 169(5): 1119-24.

  40. Tanos V, RN. Prophylactic antibiotics in abdominal hysterectomy. J Am Coll Surg 1993; 179(5): 593-600.

  41. Maleemonkol S, Charconiam V, Isariyodom P, Chaiyapan S. Comparison of short versus long duration of ampicillin and gentamicin for radical hysterectomy. J Med Assoc Thai 1998; 81(8): 602-07.

  42. Chongsomchai C, Lumbiganon P, Thinkhamrop J, Ounchai J, Vudhikamraksa N. Placebo-controlled, double-blind, randomized study of prophylactic antibiotics in elective abdominal hysterectomy. J Hosp Infect 2002; 52(4): 302-06.

  43. Eason EL, Wells G, Garber GE, Hopkins ML; Vaginal Antisepsis for Abdominal Hysterectomy Study Group. Prophylactic antibiotics for abdominal hysterectomy: indication for low-risk Canadian women. J Obstet Gynaecol Can 2004; 26(12): 1067-72.

  44. Gadducci A, Cosio S, Spirito N, Genazzani AR. The perioperative management of patients with gynecological cancer undergoing major surgery: A debated clinical challenge. Crit Rev Oncol Hematol 2010; 73(2): 126-40.

  45. ACOG practice bulletin No. 104: antibiotic prophylaxis for gynecologic procedures. Obstet Gynecol 2009; 113(5): 1180-9.

  46. Orr JW, SF, Patsner B, Barrett JM, Ellington JR, Jennings RH, et al. Single-dose antibiotic prophylaxis for patients undergoing extended pelvic surgery for gynecologic malignancy. Am J Obstet Gynecol 1990; 162(3): 718-21.

  47. Mayer HO, Petru E, Haas J, Heydarfadai M. Perioperative antibiotic prophylaxis in patients undergoing radical surgery for gynecologic cancer: single dose versus multiple dose administration. Eur J Gynecol Oncol 1993; 14(3): 177-81.

  48. Penel N, YazdapanahY, Cahuvet M, Clissant S, et al. Prevention of surgical site infections after breast cancer surgery by targeted prophylaxis antibiotic in patients at high risk of surgical site infection. J Surg Oncol 2007; 96(2): 124-9.

  49. Platt R, et al. Perioperative antibiotic-prophylaxis for herniorrhaphy and breast surgery. New Engl J Med 1990; 322(3): 153-60.

  50. Amland PF, et al. A prospective, double-blind, placebo-controlled trial of a single-dose of azithromycin on postoperative wound infections in plastic-surgery. Plast Reconstruct Surg 1995; 96(6): 1378-83.

  51. Gupta R, et al. Antibiotic prophylaxis for post-operative wound infection in clean elective breast surgery. Eur J Surg Oncol 2000; 26(4): 363-6.

  52. Wagman LD, et al. A prospective, randomized double-blindstudy of the use of antibiotics at the time of mastectomy. Surg Gynecol Obstet 1990; 170(1): 12-16.

  53. Vilar-Compte D. Uso de los antibióticos profilácticos en mastectomía para la prevención de las infecciones del sitio quirúrgico. Experiencia de 4 años en el Instituto Nacional de Cancerología. En: XXXIII Congreso Nacional de la Asociación Mexicana de Infectología y Microbiología Clínica. 2008. León, Guanajuato, Mexico: Grapondi.

  54. Tejirian T, Di Fronzo LA, Haigh PI. Antibiotic prophylaxis for preventing wound infection after breast surgery: A systematic review and meta-analysis. J Am Coll Surg 2006; 203(5): 729-34.

  55. Thockmorton AD, HoskinT, Bootstrom SY, Boughey JC, Holifield AC, Stobbs MC, et al. Complication associated with postoperative prophylaxis after breast surgery. Am J Surg 2009; 198(4): 553-6.

  56. Wolff JS Jr, Bennet CJ, Dmochowski RR, Hollenbeck BK, Pearl MS, Schaeffer AJ, et al. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol 2008; 179(4): 1379-90.

  57. Bootsma AM, Laguna Pes MP, Geerlings SE, Goosens A. Antibiotic prophylaxis in urologic procedures: a systematic review. Eur Urol 2008; 54(6): 1270-86.

  58. Grabe M. Perioperative antibiotic prophylaxis in urology. Curr Opin Urol 2001; 11: 81-5.

  59. Grabe M. Controversies in antibiotic prophylaxis in urology. Int J Antimicrob Agents 2004; 23(Suppl. 1): S17-S23.

  60. Lange D, Zappanga C, Hamidizadeh R, Goldenberg SL, Paterson SF, Chew BH, et al. Bacterial sepsis after prostate biopsy. A new perspective. Urology 2009; 74(6): 1200-5.

  61. Aron M, Rajeev TP, Gupta NP. Antibiotic prophylaxis for transrectal needle biopsy of the prostate: a randomized controlled study. BJU 2000; 85(6): 882-5.

  62. Berry A, BA. Prophylactic antibiotic use in transurethral prostatic resection: a meta-analysis. J Urol 2002; 167 (2, Pt. 1): 571-7.

  63. Qiang W, Jianchen W, MacDonald R, Monga M, Wilt TJ. Antibiotic prophylaxis for transurethral prostatic resection in men with preoperative urine containing less than 100,000 bacteria per ml: a systematic review. J Urol 2005; 173(4): 1175-81.

  64. Guajardo-Lara CE, G-MP, Ayala-Gaytan JJ. Antibiotic resistance of E. coli from community-acquired urinary tract infections. What antimicrobials to use? Sal Pub Mex 2009; 51(2): 155-9.

  65. Cornejo-Juárez P, Velasquez-Acosta C, Sandoval S, Gordillo P, Volkow-Fernández P. Antimicrobial resistance patterns of isolates from urine cultures at an oncological center. Sal Pub Mex 2007; 49(5): 330-6.

  66. Arreguin V, Cebada M, Simon JI, Sifuentes-Osornio J, Bobadilla- del Valle M, Macias AE. Microbiology of urinary tract infections in ambulatory patients. Therapeutic options in times of high antibiotic resistance. Rev Invest Clin 2007; 59(4): 239-45.

  67. Matsumoto T, Kiyota H, Matsukawa M, Yasuda M, Arakawa S, Monden K. Japanese guidelines for prevention of perioperative infections in urological field. Int J Urol 2007; 14(10): 890-909.

  68. Naber KG, Bergman B, Bishop MC, Bjerklund-Johansen TE, Botto H, Lobel B, et al. EAU guidelines for the management of urinary and male genital tract infections. Urinary Tract Infection (UTI) Working Group of the Health Care Office (HCO) of the European Association of Urology (EAU). Eur Urol 2001; 40(5): 576-88.

  69. Jeys L, Grimer R. The long term risks of infection and amputation with limb salvage surgery using endoprostheses. Recent Results Cancer Res 2009; 179: 75-84.

  70. Schussler O, Dermine H, Alifano M, Cassetta A, Coignar S, Roche N, et al. Should we change antibiotic prophylaxis for lung surgery? Postoperative pneumonia is the critical issue. Ann Thorac Surg 2008; 86(6): 1727-33.

  71. Radu DM, Jauréguy F, Seguin A, Foulon C, Destable MD, Azorin J, Martinod E, et al. Postoperative pneumonia after major pulmonary resections: an unsolved problem in thoracic surgery. Ann Thorac Surg 2007; 84(5): 1669-73.




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