BMC infectious diseases · 2026
Extending prophylactic antimicrobial use beyond 48 h postoperatively fails to reduce surgical site infections and other healthcare-associated infections in patients undergoing colorectal resection: a Propensity Score Matching study.
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Yang Yujuan, Bao Zhenjie, Zhang Zhujun
Аннотация
BACKGROUND: It is controversial whether antibiotic should be used prophylactically 48 h after colorectal resection. Hence, the association of prophylactic antimicrobial (PA) use beyond 48 h postoperatively with the incidence of surgical site infections (SSI) and other healthcare-associated infections (HAI) in patients receiving colorectal resection surgery was evaluated.
METHODS: A retrospective analysis was performed on 2691 patients who underwent colorectal resection between March 1, 2023, and December 31, 2025. Patients were categorized into the non-PA beyond 48 h postoperatively group (n = 1934) and the PA beyond 48 h postoperatively group (n = 757) based on whether prophylactic antibiotic use exceeded 48 h postoperatively. Propensity Score Matching (PSM) was used to balance differences in covariates between the two groups, subsequently, the relationship between prophylactic antibiotic use and infection was analyzed.
RESULTS: The incidence of surgical site infections (SSI) in patients undergoing colorectal resection was 8.51% (229/2691), while the incidence of other healthcare-associated infections (HAI) was 8.06% (217/2691). After PSM, both non-PA beyond 48 h postoperatively group and PA beyond 48 h postoperatively group were divided into 757 cases each. Multiple regression analysis showed that PA beyond 48 h postoperatively was not associated with SSI(OR = 0.85, 95% CI 0.59 -1.21, P = 0.356) and other HAI (OR = 0.81, 95% CI 0.54-1.23, P = 0.325) after adjustment for the confounding effect of age, sex, diabetes, hypertension, anemia, hypoproteinemia. Subsequent to adjustment for all confounding factors, PA beyond 48 h postoperatively was still not a influence factor for SSI (OR = 0.85, 95% CI 0.59-1.22, P = 0.372) and other HAI (OR = 0.77, 95% CI 0.50-1.18, P = 0.229). The total cost (¥57349.60 vs. ¥55039.10, P = 0.0006) were higher in the PA beyond 48 h postoperatively group than non-PA beyond 48 h postoperatively group, and no statistically significant differences were observed between the two groups in postoperative hospital stay (P > 0.05).
CONCLUSION: Extending prophylactic antimicrobial use beyond 48 h postoperatively following colorectal resection surgery was not associated with lower morbidity rate of SSI and other HAI, nor did it shorten the postoperative hospital stay; however, it resulted in elevated costs. Nonetheless, this study may contribute to the development of strategies for standardizing prophylactic medication management during the perioperative period of colorectal resection.
CLINICAL TRIAL NUMBER: Not applicable.
METHODS: A retrospective analysis was performed on 2691 patients who underwent colorectal resection between March 1, 2023, and December 31, 2025. Patients were categorized into the non-PA beyond 48 h postoperatively group (n = 1934) and the PA beyond 48 h postoperatively group (n = 757) based on whether prophylactic antibiotic use exceeded 48 h postoperatively. Propensity Score Matching (PSM) was used to balance differences in covariates between the two groups, subsequently, the relationship between prophylactic antibiotic use and infection was analyzed.
RESULTS: The incidence of surgical site infections (SSI) in patients undergoing colorectal resection was 8.51% (229/2691), while the incidence of other healthcare-associated infections (HAI) was 8.06% (217/2691). After PSM, both non-PA beyond 48 h postoperatively group and PA beyond 48 h postoperatively group were divided into 757 cases each. Multiple regression analysis showed that PA beyond 48 h postoperatively was not associated with SSI(OR = 0.85, 95% CI 0.59 -1.21, P = 0.356) and other HAI (OR = 0.81, 95% CI 0.54-1.23, P = 0.325) after adjustment for the confounding effect of age, sex, diabetes, hypertension, anemia, hypoproteinemia. Subsequent to adjustment for all confounding factors, PA beyond 48 h postoperatively was still not a influence factor for SSI (OR = 0.85, 95% CI 0.59-1.22, P = 0.372) and other HAI (OR = 0.77, 95% CI 0.50-1.18, P = 0.229). The total cost (¥57349.60 vs. ¥55039.10, P = 0.0006) were higher in the PA beyond 48 h postoperatively group than non-PA beyond 48 h postoperatively group, and no statistically significant differences were observed between the two groups in postoperative hospital stay (P > 0.05).
CONCLUSION: Extending prophylactic antimicrobial use beyond 48 h postoperatively following colorectal resection surgery was not associated with lower morbidity rate of SSI and other HAI, nor did it shorten the postoperative hospital stay; however, it resulted in elevated costs. Nonetheless, this study may contribute to the development of strategies for standardizing prophylactic medication management during the perioperative period of colorectal resection.
CLINICAL TRIAL NUMBER: Not applicable.