Antibiotic Prophylaxis In Elective Laparoscopic Cholecystectomy: A Prospective, Randomized And Double Blind Study [antibioticoprofilaxia Na Colecistectomia Videolaparoscópica Eletiva: Estudo Prospectivo Randomizado E Duplo Cego]

Background: To identify the need for aintibiotic prophylaxis usage in routine laparoscopic cholecystectomy. Methods: A prospective, randomized double-blind study was done in patients submitted to routine laparoscopic cholecystectomy from June 2003 to July 2007, with 163 patients divided in two groups: Group A (n=82) received antibiotic prophylaxis with Cefoxitin 2g IV at anesthesia induction; Group B (n=81) received 2 mL of isotinic sodium chloride solution at same time. Surgical technique and team were the same. The purpose of this study was to search the outcome for surgical site ifections and superficial or deep abscesses. The patients were examined at 7 and 28 days after surgery. Data were analyzed by Fisher's exact test. Results: This study showed infection complication rates of 4.76% in group A and 6.17% in group B. There were no statistical significant differences (p = 0.746) for infection complication rates in both groups. The groups were homogeneous and comparable. Conclusions: Patients submitted to routine laparoscopic cholecystectomy with low surgical risk do not need antibiotic prophylaxis, because it will not result in lower infection rates.353168172McGuckin, M., Shea, J.A., Schwartz, J.S., Infection and antimicrobial use in laparoscopic cholecystectomy (1999) Infect Control Hosp Epidemiol, 20 (9), pp. 624-626Shea, J.A., Healey, M.J., Berlin, J.A., Clarke, J.R., Malet, P.F., Staroscik, R.N., Schwartz, J.S., Williams, S.V., Mortality and complications associated with laparoscopic cholecystectomy. A meta-analysis (1996) Ann Surg, 224 (5), pp. 609-620Higgins, A., London, J., Charland, S., Ratzer, E., Clark, J., Haun, W., Maher, D.P., Prophylatic antibiotics for elective laparoscopic cholecystectomy: Are they necessary? (1999) Arch Surg, 134 (6), pp. 611-613. , discussion 614Shindholimath, V.V., Seenu, V., Parshad, R., Chaudhry, R., Kumar, A., Factors influencing wound infection following laparoscopic cholescytectomy (2003) Trop Gastroenterol, 24 (2), pp. 90-92Chang, W.T., Lee, K.T., Chuang, S.C., Wang, S.N., Kuo, K.K., Chen, J.S., Sheen, P.C., The impact of prophylactic antibiotics on postoperative infection complication in elective laparoscopic cholecystectomy: A prospective randomized study (2006) Am J Surg, 191 (6), pp. 721-725Mouret, P., From the first laparoscopic cholecystectomy to the frontiers of laparoscopic surgerythe futures prospectives (1991) Dig Surg, 8, pp. 124-125Dubois, F., Berthelot, G., Levard, H., Laparoscopic cholecystectomy: Historic perspective and personal experience (1991) Surg Laparosc Endosc, 1 (1), pp. 52-57Illig, K.A., Schmidt, E., Cavanaugh, J., Krusch, D., Sax, H.C., Are prophylactic antibiotics required for elective laparoscopic cholecystectomy? 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Epidemiol, 18 (6), pp. 449-456Knight, R., Charbonneau, P., Ratzer, E., Zeren, F., Haun, W., Clark, J., Prophylactic antibiotics are not indicated in clean general surgery cases (2001) Am J Surg, 182 (6), pp. 682-686Schilling, J., Michalopoulos, A., Geroulanos, S., Antibiotic prophylaxis in gastroduodenal surgery (1997) Hepatogastroenterology, 44 (13), pp. 116-120Souza, H.P., Breigeiron, R., Vilhordo, D.W., Infecção em cirurgia (2008) Condutas em cirurgia geral, pp. 50-57. , Cavazzola LT, editor, Porto Alegre: Artmed;Silver, A., Eichorn, A., Kral, J., Pickett, C., Barie, P., Pryor, V., Dearie, M.B., Timeliness and use of antibiotic prophylaxis in selected inpatient surgical procedures. The Antibiotic Prophylaxis Study Group (1996) Am J Surg, 171 (6), pp. 548-552Ferraz, A.A.B., Leão, C.S., Campos, J.M., Martins Filho, E., Albuquerque, A.C., Ferraz, E.M., Profilaxia antibiótica na cirurgia bariátrica: Ampicilina/sulbactam x ceftriaxona x ertapenem. 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Philadelphia: Lippincott;Horan, T.C., Gaynes, R.P., Martone, W.J., Jarvis, W.R., Emori, T.G., CDC definitions of nosocomial surgical site infections, 1992: A modification of CDC definitions of surgical wound infections (1992) Infect Control Hosp Epidemiol, 13 (10), pp. 606-608Koc, M., Zulfikaroglu, B., Kece, C., Ozalp, N., A prospective randomized study of prophylactic antibiotics in elective laparoscopic cholecystectomy (2003) Surg Endosc. 2003, 17 (11), pp. 1716-1718. , Epub Jun 17Tocchi, A., Lepre, L., Costa, G., Liotta, G., Mazzoni, G., Maggiolini, F., The need for antibiotic prophylaxis in elective laparoscopic cholecystectomy: A prospective randomized study (2000) Arch Surg, 135 (1), pp. 67-70. , discussion 70Catarci M, Mancini S, Gentileschi P, Camplone C, Sileri P, Grassi GB. Antibiotic prophylaxis in elective laparoscopic cholescystectomy. Lack of need or lack of evidence? Surg Endosc. 200418(4):638-41. 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More Prevalent Prescription of Medicine for Hypertension and Metabolic Syndrome in Males from Couples Undergoing Intracytoplasmic Sperm Injection

Register-based studies have indicated that men with impaired fertility are at higher risk for developing various adult-onset diseases than fertile men. The majority of men undergoing ICSI treatment are sub-fertile and since they are in contact with the health care system, these men are well suited as target for preventive measures. Our study included all men (N = 459 766) who had fathered children in Sweden between 2006 and 2016. Swedish registry data was used for obtaining information regarding conception method and defining three groups of fathers – ICSI -treated, IVF – treated and non IVF/ICSI. By sourcing data from the Swedish Prescribed Drug Register, we specifically searched for information regarding prescription and usage of at least one prescription for diabetes mellitus, hypertension (HT) or dyslipidemia to serve as a proxy for metabolic disease among the study groups. If all three types of medicine were prescribed, the patient was considered as having metabolic syndrome. Our results indicate male partners in couples who became parents using ICSI to be at higher risk for being treated for hypertension (HR = 1.15 95% CI: 1.06–1.24, p = 0.001) and metabolic syndrome (HR = 1.28 95% CI: 1.01–1.58, p = 0.042) when compared to non IVF/ICSI men