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Significance and Alterations After Antibiotic Therapy

Henry A. Pitt, MD; Russell G. Postier, MD; John L. Cameron, MD

Arch Surg. 1982;117(4):445-449.

Abstract
• Patients undergoing urgent and complex biliary operations were studied to determine (1) whether bactibilia is associated with postoperative complications and (2) whether antibiotic therapy influences biliary bacteriology. Aerobic and anaerobic cultures were performed on hepatic bile obtained at surgery in 134 patients. Cultures were repeated four to seven days postoperatively in 111 patients who had indwelling biliary tubes. Positive operative bile cultures were associated with an increased incidence of wound infection and postoperative renal dysfunction. Postoperative bile cultures showed a significant increase in the number of patients having bactibilia, and a significant alteration in the types of organisms isolated. Anaerobes were cultured from 15% of operative and 23% of postoperative cultures. Antibiotic therapy did not sterilize bile, but merely altered biliary bacteriology. Furthermore, prolonged aminoglycoside therapy was associated with a high incidence of renal dysfunction, especially in elderly patients.

(Arch Surg 1982;117:445-449.

Author Affiliations
From the Department of Surgery, The Johns Hopkins Medical Institutions, Baltimore. Dr Postier is now with the Department of Surgery, University of Oklahoma, Oklahoma City; Dr Pitt is now with the Department of Surgery, UCLA School of Medicine, Los Angeles.

Footnotes
Accepted for publication Nov 23, 1981.

Read at the fifth annual surgical symposium of the Association of Veterans Administration Surgeons, Minneapolis, May 14, 1981.

Reprint requests to 77-130 Center for the Health Sciences, UCLA, Los Angeles, CA 90024 (Dr Pitt).

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