[Should antibiotic prevention be used in biliary tract surgery?].

A prospective, controlled, double-blind, randomized multicentre trial in Switzerland has been conducted to investigate the effectiveness of 5 g mezlocillin given during induction of anesthesia for prevention of infectious complications in biliary tract surgery. All adults undergoing elective or emergency surgery were included. Single-dose prevention reduces the incidence of wound infections from 10% to 4%, but does not reduce other kinds of infectious complications. The incidence of wound infections in the control group in Switzerland is only about half that in other countries. It is concluded that administration of single-dose mezlocillin to all patients in this type of surgery is justified. On the basis of risk factors it is impossible to predict reliably the patients who do not need protection.