Is 72 h of antimicrobial prophylaxis better than 24 h in elective gastric cancer surgery ?

Background/aim: The optimum duration of antimicrobial prophylaxis in elective gastric cancer surgery is still not yet established. The aim of this study is to evaluate the efficacy of 24 h or 72 h of antimicrobial prophylaxis for preventing postoperative infection. Materials and methods: Between July 2016 and January 2018, 990 gastric cancer patients undergoing surgery with D2 lymphadenectomy in Ren Ji Hospital were classified into 24-h or 72-h antimicrobial prophylaxis groups. The incidence of postoperative infection complications was compared. Results: A total of 990 patients (24-h antimicrobial prophylaxis, 708 cases; 72-h antimicrobial prophylaxis, 282 cases) were analyzed. Surgical site infection (SSI) occurred in 37 patients (5.2%) in the 24-h group and 17 patients (6.0%) in the 72-h group, respectively, and 24-h antimicrobial prophylaxis was not a risk factor for remote infection (11.2% in 24-h versus 10.2% in 72-h group). Age > 60 years and pathological stage III were significantly associated with remote infection. Conclusion: Compared to 72 h of antimicrobial prophylaxis, 24 h is not a risk factor for either SSI or remote infection. Extended antimicrobial prophylaxis might decrease remote infections for older patients or those of pathological stage III.