Are We Justified in Giving Single-dose Preoperative Antibiotic Prophylaxis for Elective Laparoscopic Cholecystectomy?

Aim: To determine the difference in the rate of surgical site infection (SSI), duration of hospital stay, and cost of treatment in single-dose (SD) (2 gm cefazolin) vs multiple dose (MD) antibiotic prophylaxis in elective laparoscopic cholecystectomy. Study design: Single-center prospective observational cohort study – 160 patients (80 in each arm). Place and duration of study: Surgical Department, Kasturba Hospital, Manipal, India, from Jan 2021 to July 2022 Materials and methods: Patients of both genders age >18 years, irrespective of their comorbidity status were selected if they fulfil the eligibility criteria. They were described about the nature of the study and written consent was taken if they were willing to take part in the study and placed in their respective groups based on the antibiotic, they received according to the operating surgeon (SD grouped received SD of Cefazolin 2 g before surgery, MD received MD of antibiotics). All the surgical procedures were carried out as regular standard of care. All patients were followed up for 1 month and data was collected regarding their hospital stay, final bill and SSI. Results: There is no significant difference in the rate of surgical wound infections between SD (cefazolin 2 g) and MD antibiotic prophylaxis for elective laparoscopic cholecystectomy (p = 0.216). The single-dose group had a slightly shorter length of hospital stay (0.48 days) (p = 0.278) and a significant difference in the cost of hospitalization (Rs 7,756) (p = 0.001). Conclusion: When it comes to preventing SSIs after laparoscopic cholecystectomy, prophylaxis with an SD of cefazolin 2 g is equally effective as MDs of antibiotic prophylaxis. Moreover, the SD regime has the advantage of a comparatively shorter hospital stay as well as lower treatment costs for the patient.