Background Despite progress made in the control of postoperative
infections, the incidence of surgical site infections
(SSIs) is still high. An improper perioperative antibiotic use
can expose patients to the risk of resistant microorganisms,
and, in surgical obese patients, the drug dosage and infusion
time are critical points. The aim of our study was to evaluate
the effectiveness of ertapenem in the prophylaxis of SSIs in
obese patients undergoing general or bariatric surgery.
Methods A total of 63 obese patients, candidates for several
surgical interventions, were enrolled and divided into two
groups. Patients received antibiotic prophylaxis before surgery:
the case group received venous infusion of ertapenem;
the control group received standard prophylaxis. Serum
samples were tested for antimicrobial activity against
Gram-positive and Gram-negative bacteria.
Results After single-dose ertapenem in obese patients, we
registered in vitro activity of sera against the growth of nonextended
beta lactamase (ESBL)-producing Escherichia
coli, Proteus mirabilis, Citrobacter freundii, Enterobacter
cloacae, and non-ESBL-producing Klebsiella pneumoniae.
Moreover, methicillin-sensitive Staphylococcus aureus and
Streptococcus viridans were also inhibited. We found in
vivo efficacy according to clinical monitoring: at the weekly
and monthly follow-ups, one patient in the case group and
six patients in the control group presented superficial
incisional SSIs.
Conclusions These preliminary results are suggestive of the
efficacy of ertapenem in perioperative prophylaxis of SSIs
in obese patients; however, they need to be confirmed by
further investigations and more defined trials