Feasibility of oral antibiotic prophylaxis in elective laparoscopic cholecystectomy during periods of limited cefazolin supply.

INTRODUCTION: In March 2019, the supply of cefazolin sodium (CEZ) became difficult owing to contamination of the drug substance. We investigated the efficacy and safety of the oral administration of cephalexin (CEX) in preventing infectious complications following elective laparoscopic cholecystectomy (LC). METHODS: From July 2018 to June 2019, 1 g of CEZ was administered intravenously within 30 min prior to LC (IV group). From July 2019 to June 2020, 0.5 g of CEX was administrated orally within 2 h prior to LC (oral group). We compared clinicopathologic variables and perioperative results between these two groups. RESULTS: During the period, 60 patients underwent elective LC; 35 from the oral group and 25 from the IV group. There was no significant difference in the surgical site infection (P = 0.37), distant infection (P = 0.23), and postoperative medical costs (P = 0.11) between both groups. Postoperative nausea and vomiting were significantly higher in the oral group (P = 0.04), whereas the C-reactive protein value on the first day after the operation was significantly lower in the oral group (P < 0.01). CONCLUSION: During the period of limited CEZ supply, oral administration of CEX may be an alternative antibiotic prophylaxis in LC.