Antibiotic Prophylaxis in Metabolic Bariatric Surgery

Nature and Extent of the Burden and Risks:

Rationale:

• Cost-Effectiveness: Reducing antibiotic use could lower surgical costs.
• Resource Utilization: Simplifying protocols save hospital resources.
• Antibiotic Resistance: Reducing use helps combat resistant bacteria.
• Adverse Reactions: Fewer antibiotics may reduce side effects.

Risk Assessment:

• Increased Infection Rates: Monitor SSI and organ/space SSI rates closely.
• Anastomotic Leaks and Reoperations: Assess the impact on leaks and operations.
• Readmissions and Postoperative Interventions: Evaluate the effect on readmission and intervention rates.

Group Relatedness:

Comparing groups with and without antibiotics provides evi-dence-based insights into the safety of modifying standard practices to optimize health outcomes and resource use.

Inclusion criteria

° Patients must be older than 18 and meet the eligibility criteria for MBS as outlined by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) and the Dutch Federation of Medical Specialists for the surgical treatment of obesity.

Exclusion criteria

• Patients undergoing immunotherapy or corticosteroid treatment for Crohn's disease or rheumatoid arthritis.
• Patients with a history of endocarditis require prophylactic antibiotics.
• Patients with known severe allergies to antibiotics.
• Patients with active infections or recently treated with antibiotics (within the last 30 days).
• Patients with compromised immune systems, including those with HIV/AIDS or undergoing chemotherapy.
• Patients with chronic liver or kidney disease.
• Patients with uncontrolled diabetes (HbA1c > 9%).
• Patients with a history of previous metabolic bariatric surgery.
• Pregnant or breastfeeding women.
• Patients with any other medical condition that, in the opinion of the investigator, would compromise the patient's safety or the study's integrity.