As perioperative antibiotic prophylaxis, current guidelines recommend a first-generation cephalosporin. On the other hand, some research supports the use of tailored antibiotics. For a study, the researchers sought to assess the effectiveness of preventive targeted antibiotics vs regular antibiotics in preventing post-pancreatoduodenectomy infections. From 1946 through July 2020, investigators searched MEDLINE, EMBASE, and the Cochrane library. Studies that compared targeted antibiotics to normal perioperative antibiotics and included data on surgical site infections (SSI) were included. Perioperative antibiotics targeting pathogens found in biliary instruments or culture data acquired from the patient or institution were considered targeted therapy. The rate of SSIs and their microbiological profile were evaluated as outcomes. Demographic information, perioperative antibiotics, postoperative products, including microbiology data, and meta-analysis were all examined. A total of 849 patients receiving pancreatoduodenectomy were included in seven trials. Compared to standard antibiotic therapy, targeted antibiotics were linked with a considerably lower rate of postoperative SSI [21.1% vs 41.9%; risk ratios (RR) 0.55, 95% CI 0.37–0.81]. Patients who received targeted antibiotic prophylaxis had decreased rates of wound/incisional site infections and organ space infections (RR 0.33, P=0.0002 and RR 0.54, P=0.0004, respectively). The most prevalent bacteria found were Enterococcus species. There was a considerable drop in overall SSI rates when targeted antibiotics were utilized. Antibiotic prophylaxis was insufficient to cover bacteria commonly seen in postoperative infections after pancreatoduodenectomy.
