{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:15:22Z","timestamp":1788434122229,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["23AA2003"],"award-info":[{"award-number":["23AA2003"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["24AA2006"],"award-info":[{"award-number":["24AA2006"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite improvements in surgical techniques and perioperative management, the incidence of postoperative surgical site infection after pancreatoduodenectomy remains high. This study aim to assess whether broad\u2010spectrum antibiotic prophylaxis can reduce complications after pancreatoduodenectomy compared with standard care antibiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data of patients who underwent pancreatoduodenectomy between July 2010 and March 2022 were extracted from a nationwide Japanese inpatient database. First\u2010 and second\u2010generation cephalosporins were designated as narrow\u2010spectrum, and third\u2010 and fourth\u2010generation cephalosporins and piperacillin\u2013tazobactam as broad\u2010spectrum antibiotics. Patients who received either narrow\u2010 or broad\u2010spectrum antibiotics on the day of surgery were included in the analysis. Using propensity\u2010score stabilized inverse probability of treatment weighting, the postoperative complications were compared between patients who received antimicrobial prophylaxis with narrow\u2010spectrum antibiotics versus broad\u2010spectrum antibiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From among 45\u2009099 eligible patients, 36\u2009742 (81.5%) and 8357 (18.5%) patients received narrow\u2010 and broad\u2010spectrum antibiotics, respectively. After stabilized inverse probability of treatment weighting, the use of broad\u2010spectrum antibiotics bore a significant association with the reduction in intra\u2010abdominal infections [risk difference (RD), \u22127.4; 95% confidence interval (CI), \u22128.7 to \u22126.0], postoperative pancreatic fistula (RD, \u22123.0; 95% CI, \u22124.0 to \u22121.9), post\u2010pancreatectomy hemorrhage (RD, \u22121.5; 95% CI, \u22121.9 to \u22121.1). The use of broad\u2010spectrum antibiotics was also associated with a shorter postoperative length of hospital stay and lower total hospitalization costs. The proportion of\n                      <jats:italic>Clostridioides difficile<\/jats:italic>\n                      infection did not differ between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The administration of broad\u2010spectrum antibiotics as antimicrobial prophylaxis was associated with better in\u2010hospital postoperative outcomes compared with narrow\u2010spectrum in patients undergoing pancreatoduodenectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ags3.70198","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:48:50Z","timestamp":1772966930000},"page":"1231-1238","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Broad\u2010Spectrum Antibiotic Prophylaxis on Post\u2010Pancreatoduodenectomy Infectious Complications: Nationwide Inpatient Database Study in Japan"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1651-0091","authenticated-orcid":false,"given":"Hiroki","family":"Kitagawa","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Hiroshima University Hospital  Hiroshima Japan"},{"name":"Department of Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shotaro","family":"Aso","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3976-2278","authenticated-orcid":false,"given":"Yuki","family":"Hirano","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary\u2010Pancreatic and Gastrointestinal Surgery International University of Health and Welfare School of Medicine  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichiro","family":"Uemura","sequence":"additional","affiliation":[{"name":"Department of Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6433-3184","authenticated-orcid":false,"given":"Keita","family":"Kouzu","sequence":"additional","affiliation":[{"name":"Department of Surgery National Defense Medical College  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8441-2755","authenticated-orcid":false,"given":"Satoru","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Surgery Keio University School of Medicine  Tokyo 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