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

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Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusion

A preemptive 5-day postoperative course of moxifloxacin does not reduce the incidence of pulmonary infection and does not improve mortality after thoracoabdominal esophagectomy.

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Acknowledgements

We would like to thank Anuradha Gunale M.D., Ph.D. for proof-reading the manuscript.

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Authors and Affiliations

  1. Department of Anesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Marcel Hochreiter, Maria Uhling, Marc Moritz Berger, Daniel Christoph Richter, Markus Alexander Weigand & Cornelius Johannes Busch

  2. Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany

    Leila Sisic, Thomas Schmidt & Markus Büchler

  3. Institute of Medical Biometry and Informatics, Heidelberg University Hospital, Heidelberg, Germany

    Thomas Bruckner

  4. Department of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany

    Alexandra Heininger

  5. Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany

    Andreas Hohn

  6. Department of Surgery, RoMed Klinikum, Rosenheim, Germany

    Katja Ott

  7. Department of Anesthesiology, Perioperative and General Critical Care Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria

    Marc Moritz Berger

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  1. Marcel Hochreiter
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Correspondence to Cornelius Johannes Busch.

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Hochreiter, M., Uhling, M., Sisic, L. et al. Prolonged antibiotic prophylaxis after thoracoabdominal esophagectomy does not reduce the risk of pneumonia in the first 30 days: a retrospective before-and-after analysis. Infection 46, 617–624 (2018). https://doi.org/10.1007/s15010-018-1160-2

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