1454. Ertapenem for the Prevention of Surgical Site Infection Following Colorectal Surgery
Session: Poster Abstract Session: HAI: Surgical Site Infections
Friday, October 28, 2016
Room: Poster Hall
Posters
  • 1454_IDWEEKPOSTER.pdf (220.0 kB)
  • Background:

    Recent data from randomized control trials suggest ertapenem prophylaxis may be superior to cefotetan for prevention of surgical site infections (SSIs) in colorectal surgeries, however, these trials may have limited generalizability. The primary objective of this study was to compare the frequency of SSI in patients receiving ertapenem and other prophylactic regimens prior to colorectal surgery.

    Methods:

    We conducted a retrospective cohort study of adult patients (age ≥ 18 years) undergoing colorectal procedures between Jul. 2012 and Sept. 2015. Patients with history of surgery in the prior 30 days, surgery due to trauma, or systemic antibiotics at the time of surgery were excluded. The primary outcome was surgical site infection within 30 days of surgery; outcome frequencies were compared between patients receiving ertapenem and other antibiotics for surgical prophylaxis using multivariable logistic regression to adjust for potential confounders.

    Results:

    A total of 1,129 encounters were considered for inclusion; 741 were excluded. In the 388 encounters included in the study, 296 received ertapenem and 92 received alternative prophylaxis agent(s). Patients receiving ertapenem were significantly younger (54.9 vs. 59.0 years), more likely to be male (50.7% vs. 33.7%), and have inflammatory bowel disease (26.4% vs. 8.7%). Cancer was significantly more common in patients not receiving ertapenem (80.4% vs. 69.3%). The median duration of surgery was significantly shorter among patients receiving ertapenem (178 minutes) compared to those receiving other antibiotics (212 minutes). SSI occurred in 16 (5.4%) of patients receiving ertapenem and 17 (18.5%) of patients receiving other agents (OR 0.25, 95% CI: 0.12 to 0.52). After adjusting for surgical group and surgery duration, the adjusted OR for developing SSI after ertapenem use was 0.45 (95% CI: 0.15 to 1.30).

    Conclusion:

    After adjusting for confounding, ertapenem did not significantly reduce the risk of SSI following colorectal surgery compared to alternative agents, and routine use as prophylaxis may not be warranted. Further study is needed to determine the generalizability of these findings and compare ertapenem prophylaxis to individual regimens.

    Gregory B. Tallman, PharmD1, David T. Bearden, PharmD1, James Lewis II, PharmD, FIDSA2, Miriam R. Elman, MPH1, Yoojin Kim, PhD3, Kevin Langstaff, BA3 and Jessina C. Mcgregor, PhD1, (1)Dept. Pharmacy Practice, Oregon State University/Oregon Health & Science University College of Pharmacy, Portland, OR, (2)Pharmacy, Oregon Health & Science University, Portland, OR, (3)Infection Prevention and Control, Oregon Health & Science University, Portland, OR

    Disclosures:

    G. B. Tallman, None

    D. T. Bearden, None

    J. Lewis II, None

    M. R. Elman, None

    Y. Kim, None

    K. Langstaff, None

    J. C. Mcgregor, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.