Prevention of empyema in lung surgery. A prospective, randomized study
Brynitz, S.; Friis-Møller, A.
Ugeskrift for Laeger 149(29): 1947-1951
1987
ISSN/ISBN: 0041-5782 PMID: 3324415 Document Number: 295113
A material of 180 patients participated in a prospective randomised study concerning antimicrobial prophylaxis in thoracic surgery. The patients received either A: antibiotic against their own preoperative bronchial flora or B: penicillin, or in cases of penicillin allergy, erythromycin. There were 89 and 91 in the two groups. In group A, penicillin was administered to 48 of 89 patients. Of these, 7 (15%) developed pleural empyema compared to 4 of 91 (4%) patients in group B. None of the patients undergoing resection of single segment or wedge resection developed empyema whereas 10% of the patients undergoing pneumonectomy and 14% of the patients undergoing lobectomy developed empyema. No correlation was found between the bacteriology in preoperative bronchial secretions and the bacteriology of the empyema. Preoperative culture from bronchial secretion offers no guideline for the choice of antimicrobial prophylaxis and can be omitted.