P0711 Efficacy of prophylactic antibiotics in Crohn’s disease patients: Korean IBD study group.

Abstract Background The surgical site infection (SSI) rate in Crohn’s disease (CD) surgery is reported to be approximately 10-37%, which is relatively higher compared to colon cancer surgery and colonic diverticulitis surgery. But, researches related to an appropriate use of prophylactic antibiotics (PA) for CD surgery are lacking. This study aimed to evaluate the impact of PA on incidence of SSI and to identify risk factors for SSIs in CD abdominal surgery. Methods This retrospective, multi-center, observational study was conducted by analyzing the medical records of patients who underwent intestinal surgery for CD at seven hospitals belonging to the Korea inflammatory bowel disease study group between January 2013 and January 2024. Included from the study were patients who had undergone intestinal resection, with or without anastomosis for CD. Patients were excluded if patients had undergone just open biopsy, stoma-formation, or stoma-reversal surgery. The study cohorts were divided into two groups: those who used prophylactic antibiotics for several days after surgery (Conventional antibiotics group, CA group) and those who ended antibiotics within 24 hours after surgery (Just Prophylactic antibiotics group, PA group). We compared demographics, operative results, postoperative complications in the two group. Results We identified 412 patients in CA group and 63 patients in PA group. The PA group was older age at operation time (38 years vs. 32 years, P = 0.002) and more body mass index (20.25 kg/mm2 vs. 19.05 kg/mm2, P = 0.016) than the CA group. The PA group had lesser penetrating disease for operation indication (33.3% vs. 55.3%, P = 0.001) and lesser emergent operation (3.2% vs. 12.1%, P = 0.001). There were no differences between the two groups in other demographic and operation-related variables. In terms of operative outcomes, there were no difference in the overall complication rate (PA: 17.5% vs. CA: 26.7%, P = 0.282) and infectious complication rate (PA: 11.1% vs. CA: 15.0%, P = 0.564) between two groups. The proportion of Clavien-Dindo classification 2 or more was equivalent between two groups (PA: 15.9% vs 18.2%, P = 0.727). In multivariate analysis, use of prophylactic antibiotics surgery was not protective factor for infectious complication (P = 0.571). Conclusion Discontinuing prophylactic antibiotics within 24 hours after CD surgery does not significantly impact the incidence of infectious complications. In order to derive more accurate results through a multicenter retrospective study, we plan to conduct additional analyzes such as propensity score matching based on this data. Conflict of interest: Prof. Dr. Lee, Jong Lyul: No conflict of interest Jung, Jin Min: No conflict of interest Bae, Sunguk: No conflict of interest Kim, Sohyun: No conflict of interest Baek, Se-Jin: No conflict of interest Ryoo, Seung-Bum: No conflict of interest Ju, Jae Kyun: No conflict of interest Song, Seung Ho: No conflict of interest