27ab5a90f2f57bc8e5e57f463aba8e12 pmc_34884337.pdf 1ddd2142dc60117592835248a1ccc62823e2b933 pmc_34884337.pdf 7b2bf32b32707c1c95f1ca69994878e43a995e81fbd3fe515ad59402e2cc3895 pmc_34884337.pdf Title: Oral Antibiotic Prophylaxis Lowers Surgical Site Infection in Elective Colorectal Surgery: Results of a Pragmatic Cohort Study in Catalonia Subject: Background: The role of oral antibiotic prophylaxis (OAP) and mechanical bowel preparation (MBP) in the prevention of surgical site infection (SSI) after colorectal surgery is still controversial. The aim of this study was to analyze the effect of a bundle including both measures in a National Infection Surveillance Network in Catalonia. Methods: Pragmatic cohort study to assess the effect of OAP and MBP in reducing SSI rate in 65 hospitals, comparing baseline phase (BP: 2007–2015) with implementation phase (IP: 2016–2019). To compare the results, a logistic regression model was established. Results: Out of 34,421 colorectal operations, 5180 had SSIs (15.05%). Overall SSI rate decreased from 18.81% to 11.10% in BP and IP, respectively (OR 0.539, CI95 0.507–0.573, p < 0.0001). Information about bundle implementation was complete in 61.7% of cases. In a univariate analysis, OAP and MBP were independent factors in decreasing overall SSI, with OR 0.555, CI95 0.483–0.638, and OR 0.686, CI95 0.589–0.798, respectively; and similarly, organ/space SSI (O/S-SSI) (OR 0.592, CI95 0.494–0.710, and OR 0.771, CI95 0.630–0.944, respectively). However, only OAP retained its protective effect at both levels at multivariate analyses. Conclusions: oral antibiotic prophylaxis decreased the rates of SSI and O/S-SSI in a large series of elective colorectal surgery. Keywords: colorectal surgery; surgical site infection; surgical wound infection; oral antibioticprophylaxis; mechanical bowel preparation; preventative measures Author: Josep M. Badia, Miriam Flores-Yelamos, Ana Vázquez, Nares Arroyo-García, Mireia Puig-Asensio, David Parés, Miguel Pera, Joaquín López-Contreras, Enric Limón, Miquel Pujol and Members of the VINCat Colorectal Surveillance Team Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Dec 6 07:03:48 2021 CET ModDate: Tue Dec 7 07:53:51 2021 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 10 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 455021 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- JYPLJJ+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 MWHIBA+VnURWPalladioL Type 1 Custom yes yes no 15 0 ADLOZI+URWPalladioL-Ital Type 1 Custom yes yes no 19 0 EKZOWC+URWPalladioL-Bold Type 1 Custom yes yes no 24 0 UEKJIN+URWPalladioL-Roma Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 36 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 39 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 61 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 65 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 69 0 ZYGMNY+CMSY10 Type 1 Builtin yes yes no 84 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 88 0 MMBBBK+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 105 0 MMBBCL+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 111 0 MMBBCM+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 117 0 MMBBDM+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 123 0 MMBBDN+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 126 0 MMBBDO+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 129 0 MMBDAE+PalatinoLinotype-BoldItalic CID TrueType Identity-H yes yes yes 132 0 MMBDAF+PalatinoLinotype-BoldItalic TrueType WinAnsi yes yes no 138 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2022-03-22 02:30:14 CET RepresentationInformation: pmc_34884337.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2022-01-11 05:06:56 CET Size: 455021 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 324 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Children: Item: Title: Outcomes Comparison BP IP Groups Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Overall SSI Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Organ-Space SSI Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Members of the VINCat Colorectal Surveillance Team Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Info: Title: Oral Antibiotic Prophylaxis Lowers Surgical Site Infection in Elective Colorectal Surgery: Results of a Pragmatic Cohort Study in Catalonia Author: Josep M. Badia, Miriam Flores-Yelamos, Ana Vázquez, Nares Arroyo-García, Mireia Puig-Asensio, David Parés, Miguel Pera, Joaquín López-Contreras, Enric Limón, Miquel Pujol and Members of the VINCat Colorectal Surveillance Team Subject: Background: The role of oral antibiotic prophylaxis (OAP) and mechanical bowel preparation (MBP) in the prevention of surgical site infection (SSI) after colorectal surgery is still controversial. The aim of this study was to analyze the effect of a bundle including both measures in a National Infection Surveillance Network in Catalonia. Methods: Pragmatic cohort study to assess the effect of OAP and MBP in reducing SSI rate in 65 hospitals, comparing baseline phase (BP: 2007 2015) with implementation phase (IP: 2016 2019). To compare the results, a logistic regression model was established. Results: Out of 34,421 colorectal operations, 5180 had SSIs (15.05%). Overall SSI rate decreased from 18.81% to 11.10% in BP and IP, respectively (OR 0.539, CI95 0.507 0.573, p < 0.0001). Information about bundle implementation was complete in 61.7% of cases. In a univariate analysis, OAP and MBP were independent factors in decreasing overall SSI, with OR 0.555, CI95 0.483 0.638, and OR 0.686, CI95 0.589 0.798, respectively; and similarly, organ/space SSI (O/S-SSI) (OR 0.592, CI95 0.494 0.710, and OR 0.771, CI95 0.630 0.944, respectively). However, only OAP retained its protective effect at both levels at multivariate analyses. Conclusions: oral antibiotic prophylaxis decreased the rates of SSI and O/S-SSI in a large series of elective colorectal surgery. 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