The switch prophylaxis with levofloxacin in surgical procedures for prosthetic inguinal hernia repair in one day surgery

: The installation of synthetic prosthesis in the repair of the hernial defects of the inguinal region, though it is part of cleaned surgical operations, it needs of an antibacterial prophylaxis for the prevention of the septic complications of the surgical wound and these, compared with complications following hernioplasty by straight suture, have a meaningful morbidity that can outweigh social and economic advantages of the hernioplasties. The Authors' experience is relative to 112 patients submitted to prosthetic hernioplasty by anterior approach (94 cases) and by transabdominal preperitoneal laparoscopy (TAPP) (18 cases) and underwent to "switch prophylaxis" with Levofloxacin using this posologic scheme: 500 mg ev 30 m' before the surgical operation and 500 mg os in seven days following. The evaluation of the surgical wound has never evidenced septic and suppurative complications; only 11 of the 122 surgical wounds (9%) have documented light phlogosis never advanced to evident suppuration. No patients have showed signs of pharmacologic local intolerance; about collateral general effects as sick and diarrhoea are appeared in 5% of patients, but these have been of light entity; an increase of the transaminase, quickly reverted to the suspension of the therapy, has interested 4% of cases. On the basis of these satisfactory results about clinical efficacy on the prophylaxis of the phlogistic complications of the surgical wound, with reduction of the incidence and gravity and in relation to large and complete antibacterial spectrum included Staphylococcus aureus and epidermidis, and about excellent tolerability without collateral effects, the Authors consider to be important the standardized use of this prophylaxis in the prosthetic hernial surgery of the inguinal region. This choice is correlated to the typical pharmacologic characteristics of the Levofloxacin and particularly to the total bioequivalence between endovenous and oral formulation and besides in relation to perseverance, not inferior to 24 hours, of the plasmatic and tissutal concentrations above bactericide IMC on the most part of organic districts, included skin and soft tissue. The assurance of Levofloxacin's employment in the "switch prophylaxis" also is correlated to patient's elevated compliance, above all if he is operated on regimen of "one day surgery", and to a favorable relationship between costs and benefits.