Three‐day postoperative antibiotics reduces post‐hepatectomy infection rate in hepatitis B virus‐related hepatocellular carcinoma
Background and Aim The evidences for use of postoperative antibiotics (POA) in hepatocellular carcinoma (HCC) patients who underwent hepatectomy are controversial. We aimed to explore the relationship between POA and hepatectomy‐related infection in a hepatitis B virus (HBV)‐related HCC population....
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| Veröffentlicht in: | Journal of gastroenterology and hepatology 2021-09, Vol.36 (9), p.2531-2539 |
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| creator | Chen, Zebin Jiang, Hong Wang, Yuanqi Liang, Ruiming Xu, Lixia Lai, Jiaming Shen, Jingxian Li, Jiali Li, Dongming Li, Shaoqiang Lei, Kai Zhou, Qian Peng, Baogang Peng, Hong Peng, Sui Kuang, Ming |
| description | Background and Aim
The evidences for use of postoperative antibiotics (POA) in hepatocellular carcinoma (HCC) patients who underwent hepatectomy are controversial. We aimed to explore the relationship between POA and hepatectomy‐related infection in a hepatitis B virus (HBV)‐related HCC population.
Methods
We retrospectively collected 934 HCC patients who underwent hepatectomy for curative intent from three tertiary hospitals in China. The incidences of postoperative infection including surgical site infection and remote site infection were recorded and calculated. Univariable and multivariable logistic regression analyses were performed to explore related factors of postoperative infection and POA. And the relationship between infection rates with different durations of POA was investigated.
Results
The overall infection rate was 8.2% (77/934), including 6.5% (61/934) of surgical site infection and 2.0% (19/934) of remote site infection. Multivariable analysis revealed that the administration of POA was negatively related with the incidence of postoperative infection significantly (odds ratio = 0.50, 95% confidence interval = 0.30 to 0.83; P = 0.008). Albumin‐bilirubin score, Barcelona Clinic Liver Cancer (BCLC) stage and extent of hepatectomy were independently related to the POA. And 3‐day regimen seemed to be the shortest duration of POA to gain the lowest incidence of postoperative infection.
Conclusions
Postoperative antibiotic is necessary for HBV‐related HCC patients to prevent postoperative infection, especially for those with higher albumin‐bilirubin score, at BCLC stage B–C, or who underwent major hepatectomy. For HBV‐related HCC patients, postoperative second‐generation cephalosporins, or ceftriaxone for 3 days after surgery might be proper. |
| doi_str_mv | 10.1111/jgh.15528 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2522397842</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2522397842</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4198-b9819342c16c4b3ad5ee38c59b90c755bfe9534613a7166733d24ef5014f801e3</originalsourceid><addsrcrecordid>eNp1kcFO3DAQhq0KVLbAgReoLHGhh4AnthP7WFALrZB6oefIcSasV0mc2glob9x67TP2SWo2tIdKzGVm9H_za6SfkBNg55DqYnO_Pgcpc_WGrEAIlkEpij2yYgpkpjnoA_Iuxg1jTLBSviUHnGuhtIYV-Xm3Doi_n341ZktHHyc_YjCTe0BqhsnVzk_ORhqwmS3GHZHgNY5mQjv5fkvd0KbJ-YGmO0wr3alucpFe0gcX5pguAnZJbRbNW-y6uTOBWhOsG3xvjsh-a7qIxy_9kHz__Onu6ia7_Xb95erjbWYFaJXVWoHmIrdQWFFz00hErqzUtWa2lLJuUUsuCuCmhKIoOW9yga1kIFrFAPkhOVt8x-B_zBinqnfx-R0zoJ9jlcs857pUIk_o6X_oxs9hSN8lqgTGVVGKRH1YKBt8jAHbagyuN2FbAaue06lSOtUuncS-f3Gc6x6bf-TfOBJwsQCPrsPt607V1-ubxfIPfPGeGg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2571038674</pqid></control><display><type>article</type><title>Three‐day postoperative antibiotics reduces post‐hepatectomy infection rate in hepatitis B virus‐related hepatocellular carcinoma</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Chen, Zebin ; Jiang, Hong ; Wang, Yuanqi ; Liang, Ruiming ; Xu, Lixia ; Lai, Jiaming ; Shen, Jingxian ; Li, Jiali ; Li, Dongming ; Li, Shaoqiang ; Lei, Kai ; Zhou, Qian ; Peng, Baogang ; Peng, Hong ; Peng, Sui ; Kuang, Ming</creator><creatorcontrib>Chen, Zebin ; Jiang, Hong ; Wang, Yuanqi ; Liang, Ruiming ; Xu, Lixia ; Lai, Jiaming ; Shen, Jingxian ; Li, Jiali ; Li, Dongming ; Li, Shaoqiang ; Lei, Kai ; Zhou, Qian ; Peng, Baogang ; Peng, Hong ; Peng, Sui ; Kuang, Ming</creatorcontrib><description>Background and Aim
The evidences for use of postoperative antibiotics (POA) in hepatocellular carcinoma (HCC) patients who underwent hepatectomy are controversial. We aimed to explore the relationship between POA and hepatectomy‐related infection in a hepatitis B virus (HBV)‐related HCC population.
Methods
We retrospectively collected 934 HCC patients who underwent hepatectomy for curative intent from three tertiary hospitals in China. The incidences of postoperative infection including surgical site infection and remote site infection were recorded and calculated. Univariable and multivariable logistic regression analyses were performed to explore related factors of postoperative infection and POA. And the relationship between infection rates with different durations of POA was investigated.
Results
The overall infection rate was 8.2% (77/934), including 6.5% (61/934) of surgical site infection and 2.0% (19/934) of remote site infection. Multivariable analysis revealed that the administration of POA was negatively related with the incidence of postoperative infection significantly (odds ratio = 0.50, 95% confidence interval = 0.30 to 0.83; P = 0.008). Albumin‐bilirubin score, Barcelona Clinic Liver Cancer (BCLC) stage and extent of hepatectomy were independently related to the POA. And 3‐day regimen seemed to be the shortest duration of POA to gain the lowest incidence of postoperative infection.
Conclusions
Postoperative antibiotic is necessary for HBV‐related HCC patients to prevent postoperative infection, especially for those with higher albumin‐bilirubin score, at BCLC stage B–C, or who underwent major hepatectomy. For HBV‐related HCC patients, postoperative second‐generation cephalosporins, or ceftriaxone for 3 days after surgery might be proper.</description><identifier>ISSN: 0815-9319</identifier><identifier>EISSN: 1440-1746</identifier><identifier>DOI: 10.1111/jgh.15528</identifier><identifier>PMID: 33948991</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>Albumin ; Anti-Bacterial Agents - administration & dosage ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Bilirubin ; Carcinoma, Hepatocellular - surgery ; Carcinoma, Hepatocellular - virology ; Ceftriaxone ; Cephalosporins ; Cephalosporins - administration & dosage ; Cephalosporins - therapeutic use ; Female ; Hepatectomy ; Hepatectomy - adverse effects ; Hepatitis B ; Hepatitis B virus ; Hepatitis B, Chronic - complications ; Hepatocellular carcinoma ; Humans ; Liver cancer ; Liver Neoplasms - surgery ; Liver Neoplasms - virology ; Male ; Middle Aged ; Patients ; Postoperative infection ; Retrospective Studies ; Surgical site infections ; Surgical Wound Infection - etiology ; Surgical Wound Infection - microbiology ; Surgical Wound Infection - prevention & control</subject><ispartof>Journal of gastroenterology and hepatology, 2021-09, Vol.36 (9), p.2531-2539</ispartof><rights>2021 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd</rights><rights>2021 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4198-b9819342c16c4b3ad5ee38c59b90c755bfe9534613a7166733d24ef5014f801e3</citedby><cites>FETCH-LOGICAL-c4198-b9819342c16c4b3ad5ee38c59b90c755bfe9534613a7166733d24ef5014f801e3</cites><orcidid>0000-0002-7397-5779</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgh.15528$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgh.15528$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33948991$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Zebin</creatorcontrib><creatorcontrib>Jiang, Hong</creatorcontrib><creatorcontrib>Wang, Yuanqi</creatorcontrib><creatorcontrib>Liang, Ruiming</creatorcontrib><creatorcontrib>Xu, Lixia</creatorcontrib><creatorcontrib>Lai, Jiaming</creatorcontrib><creatorcontrib>Shen, Jingxian</creatorcontrib><creatorcontrib>Li, Jiali</creatorcontrib><creatorcontrib>Li, Dongming</creatorcontrib><creatorcontrib>Li, Shaoqiang</creatorcontrib><creatorcontrib>Lei, Kai</creatorcontrib><creatorcontrib>Zhou, Qian</creatorcontrib><creatorcontrib>Peng, Baogang</creatorcontrib><creatorcontrib>Peng, Hong</creatorcontrib><creatorcontrib>Peng, Sui</creatorcontrib><creatorcontrib>Kuang, Ming</creatorcontrib><title>Three‐day postoperative antibiotics reduces post‐hepatectomy infection rate in hepatitis B virus‐related hepatocellular carcinoma</title><title>Journal of gastroenterology and hepatology</title><addtitle>J Gastroenterol Hepatol</addtitle><description>Background and Aim
The evidences for use of postoperative antibiotics (POA) in hepatocellular carcinoma (HCC) patients who underwent hepatectomy are controversial. We aimed to explore the relationship between POA and hepatectomy‐related infection in a hepatitis B virus (HBV)‐related HCC population.
Methods
We retrospectively collected 934 HCC patients who underwent hepatectomy for curative intent from three tertiary hospitals in China. The incidences of postoperative infection including surgical site infection and remote site infection were recorded and calculated. Univariable and multivariable logistic regression analyses were performed to explore related factors of postoperative infection and POA. And the relationship between infection rates with different durations of POA was investigated.
Results
The overall infection rate was 8.2% (77/934), including 6.5% (61/934) of surgical site infection and 2.0% (19/934) of remote site infection. Multivariable analysis revealed that the administration of POA was negatively related with the incidence of postoperative infection significantly (odds ratio = 0.50, 95% confidence interval = 0.30 to 0.83; P = 0.008). Albumin‐bilirubin score, Barcelona Clinic Liver Cancer (BCLC) stage and extent of hepatectomy were independently related to the POA. And 3‐day regimen seemed to be the shortest duration of POA to gain the lowest incidence of postoperative infection.
Conclusions
Postoperative antibiotic is necessary for HBV‐related HCC patients to prevent postoperative infection, especially for those with higher albumin‐bilirubin score, at BCLC stage B–C, or who underwent major hepatectomy. For HBV‐related HCC patients, postoperative second‐generation cephalosporins, or ceftriaxone for 3 days after surgery might be proper.</description><subject>Albumin</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Bilirubin</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Carcinoma, Hepatocellular - virology</subject><subject>Ceftriaxone</subject><subject>Cephalosporins</subject><subject>Cephalosporins - administration & dosage</subject><subject>Cephalosporins - therapeutic use</subject><subject>Female</subject><subject>Hepatectomy</subject><subject>Hepatectomy - adverse effects</subject><subject>Hepatitis B</subject><subject>Hepatitis B virus</subject><subject>Hepatitis B, Chronic - complications</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - surgery</subject><subject>Liver Neoplasms - virology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Postoperative infection</subject><subject>Retrospective Studies</subject><subject>Surgical site infections</subject><subject>Surgical Wound Infection - etiology</subject><subject>Surgical Wound Infection - microbiology</subject><subject>Surgical Wound Infection - prevention & control</subject><issn>0815-9319</issn><issn>1440-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcFO3DAQhq0KVLbAgReoLHGhh4AnthP7WFALrZB6oefIcSasV0mc2glob9x67TP2SWo2tIdKzGVm9H_za6SfkBNg55DqYnO_Pgcpc_WGrEAIlkEpij2yYgpkpjnoA_Iuxg1jTLBSviUHnGuhtIYV-Xm3Doi_n341ZktHHyc_YjCTe0BqhsnVzk_ORhqwmS3GHZHgNY5mQjv5fkvd0KbJ-YGmO0wr3alucpFe0gcX5pguAnZJbRbNW-y6uTOBWhOsG3xvjsh-a7qIxy_9kHz__Onu6ia7_Xb95erjbWYFaJXVWoHmIrdQWFFz00hErqzUtWa2lLJuUUsuCuCmhKIoOW9yga1kIFrFAPkhOVt8x-B_zBinqnfx-R0zoJ9jlcs857pUIk_o6X_oxs9hSN8lqgTGVVGKRH1YKBt8jAHbagyuN2FbAaue06lSOtUuncS-f3Gc6x6bf-TfOBJwsQCPrsPt607V1-ubxfIPfPGeGg</recordid><startdate>202109</startdate><enddate>202109</enddate><creator>Chen, Zebin</creator><creator>Jiang, Hong</creator><creator>Wang, Yuanqi</creator><creator>Liang, Ruiming</creator><creator>Xu, Lixia</creator><creator>Lai, Jiaming</creator><creator>Shen, Jingxian</creator><creator>Li, Jiali</creator><creator>Li, Dongming</creator><creator>Li, Shaoqiang</creator><creator>Lei, Kai</creator><creator>Zhou, Qian</creator><creator>Peng, Baogang</creator><creator>Peng, Hong</creator><creator>Peng, Sui</creator><creator>Kuang, Ming</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7397-5779</orcidid></search><sort><creationdate>202109</creationdate><title>Three‐day postoperative antibiotics reduces post‐hepatectomy infection rate in hepatitis B virus‐related hepatocellular carcinoma</title><author>Chen, Zebin ; Jiang, Hong ; Wang, Yuanqi ; Liang, Ruiming ; Xu, Lixia ; Lai, Jiaming ; Shen, Jingxian ; Li, Jiali ; Li, Dongming ; Li, Shaoqiang ; Lei, Kai ; Zhou, Qian ; Peng, Baogang ; Peng, Hong ; Peng, Sui ; Kuang, Ming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4198-b9819342c16c4b3ad5ee38c59b90c755bfe9534613a7166733d24ef5014f801e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Albumin</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Bilirubin</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Carcinoma, Hepatocellular - virology</topic><topic>Ceftriaxone</topic><topic>Cephalosporins</topic><topic>Cephalosporins - administration & dosage</topic><topic>Cephalosporins - therapeutic use</topic><topic>Female</topic><topic>Hepatectomy</topic><topic>Hepatectomy - adverse effects</topic><topic>Hepatitis B</topic><topic>Hepatitis B virus</topic><topic>Hepatitis B, Chronic - complications</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - surgery</topic><topic>Liver Neoplasms - virology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Postoperative infection</topic><topic>Retrospective Studies</topic><topic>Surgical site infections</topic><topic>Surgical Wound Infection - etiology</topic><topic>Surgical Wound Infection - microbiology</topic><topic>Surgical Wound Infection - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Zebin</creatorcontrib><creatorcontrib>Jiang, Hong</creatorcontrib><creatorcontrib>Wang, Yuanqi</creatorcontrib><creatorcontrib>Liang, Ruiming</creatorcontrib><creatorcontrib>Xu, Lixia</creatorcontrib><creatorcontrib>Lai, Jiaming</creatorcontrib><creatorcontrib>Shen, Jingxian</creatorcontrib><creatorcontrib>Li, Jiali</creatorcontrib><creatorcontrib>Li, Dongming</creatorcontrib><creatorcontrib>Li, Shaoqiang</creatorcontrib><creatorcontrib>Lei, Kai</creatorcontrib><creatorcontrib>Zhou, Qian</creatorcontrib><creatorcontrib>Peng, Baogang</creatorcontrib><creatorcontrib>Peng, Hong</creatorcontrib><creatorcontrib>Peng, Sui</creatorcontrib><creatorcontrib>Kuang, Ming</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Zebin</au><au>Jiang, Hong</au><au>Wang, Yuanqi</au><au>Liang, Ruiming</au><au>Xu, Lixia</au><au>Lai, Jiaming</au><au>Shen, Jingxian</au><au>Li, Jiali</au><au>Li, Dongming</au><au>Li, Shaoqiang</au><au>Lei, Kai</au><au>Zhou, Qian</au><au>Peng, Baogang</au><au>Peng, Hong</au><au>Peng, Sui</au><au>Kuang, Ming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Three‐day postoperative antibiotics reduces post‐hepatectomy infection rate in hepatitis B virus‐related hepatocellular carcinoma</atitle><jtitle>Journal of gastroenterology and hepatology</jtitle><addtitle>J Gastroenterol Hepatol</addtitle><date>2021-09</date><risdate>2021</risdate><volume>36</volume><issue>9</issue><spage>2531</spage><epage>2539</epage><pages>2531-2539</pages><issn>0815-9319</issn><eissn>1440-1746</eissn><abstract>Background and Aim
The evidences for use of postoperative antibiotics (POA) in hepatocellular carcinoma (HCC) patients who underwent hepatectomy are controversial. We aimed to explore the relationship between POA and hepatectomy‐related infection in a hepatitis B virus (HBV)‐related HCC population.
Methods
We retrospectively collected 934 HCC patients who underwent hepatectomy for curative intent from three tertiary hospitals in China. The incidences of postoperative infection including surgical site infection and remote site infection were recorded and calculated. Univariable and multivariable logistic regression analyses were performed to explore related factors of postoperative infection and POA. And the relationship between infection rates with different durations of POA was investigated.
Results
The overall infection rate was 8.2% (77/934), including 6.5% (61/934) of surgical site infection and 2.0% (19/934) of remote site infection. Multivariable analysis revealed that the administration of POA was negatively related with the incidence of postoperative infection significantly (odds ratio = 0.50, 95% confidence interval = 0.30 to 0.83; P = 0.008). Albumin‐bilirubin score, Barcelona Clinic Liver Cancer (BCLC) stage and extent of hepatectomy were independently related to the POA. And 3‐day regimen seemed to be the shortest duration of POA to gain the lowest incidence of postoperative infection.
Conclusions
Postoperative antibiotic is necessary for HBV‐related HCC patients to prevent postoperative infection, especially for those with higher albumin‐bilirubin score, at BCLC stage B–C, or who underwent major hepatectomy. For HBV‐related HCC patients, postoperative second‐generation cephalosporins, or ceftriaxone for 3 days after surgery might be proper.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33948991</pmid><doi>10.1111/jgh.15528</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7397-5779</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Albumin Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - therapeutic use Antibiotics Bilirubin Carcinoma, Hepatocellular - surgery Carcinoma, Hepatocellular - virology Ceftriaxone Cephalosporins Cephalosporins - administration & dosage Cephalosporins - therapeutic use Female Hepatectomy Hepatectomy - adverse effects Hepatitis B Hepatitis B virus Hepatitis B, Chronic - complications Hepatocellular carcinoma Humans Liver cancer Liver Neoplasms - surgery Liver Neoplasms - virology Male Middle Aged Patients Postoperative infection Retrospective Studies Surgical site infections Surgical Wound Infection - etiology Surgical Wound Infection - microbiology Surgical Wound Infection - prevention & control |
| title | Three‐day postoperative antibiotics reduces post‐hepatectomy infection rate in hepatitis B virus‐related hepatocellular carcinoma |
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