Randomized control trial on perioperative antibiotic prophylaxis in live liver donors: Are three doses enough?

Abstract

AbstractIntroductionThe duration of perioperative antibiotic prophylaxis following live liver donor hepatectomy (LDH) is not known.MethodsThis is a double‐blind equivalence trial. All consecutive LDH were randomized into: group A (three doses) and group B (nine doses) of perioperative antibiotics (piperacillin + tazobactam − 4.5 g intravenous) at fixed 8 hourly intervals. Primary end point was incidence of infective complications as per CDC (Centers for Disease Control and Prevention) criteria. Secondary end points were liver function tests, total leukocyte count, international normalized ratio, hospital stay, morbidity, and cost analysis.ResultsOne hundred and twenty‐six LDHs were enrolled. A total of 19.8% (n = 25) experienced postoperative complications, 11 (17.7%) in group A and 14 (21.9%) in group B (P = .561). Infective complications were seen in 11 donors (8.1%), five in group A and six in group B (P = .79). A total of 8.1% of donors required continuation/up‐gradation of antibiotics in group A and 9.4% in group B. Return to soft diet was delayed in group B (P = .039). Median hospital stay and cost were similar.ConclusionThree doses of perioperative antibiotic are equally effective in preventing infective complications.