Intraoperative Gram's staining of bile as a guide for early selective administration of antibiotics

A prospective clinicobacteriological study was undertaken in 100 patients undergoing biliary surgery, to assess the influence on the postoperative course of early antibiotic treatment that was instituted in accordance with the results of intraoperative Gram's staining of gallbladder bile. The wound infection rate was found to be 9% and there were no other septic complications. The sensitivity of Gram's staining as compared with the results of bile cultures was found to be 65.5%. This study provides additional evidence of the value of Gram's staining of bile as a means for the early discovery of pathogens and early institution of antibiotic therapy, both important factors in lowering the rate of infective postoperative complications.