Does Cefoxitin or Piperacillin-Tazobactam Prevent Postoperative Surgical Site Infections After Pancreatoduodenectomy?

Inclusion Criteria:

- Age >/= 18 years

- Patients undergoing elective pancreatoduodenectomy (PD) for any diagnosis/indication

Exclusion Criteria:

- Patients undergoing a minimally invasive PD, such as laparoscopic or robotic PD

- Patients with known and documented allergies to any of the penicillins,
cephalosporins, or β-lactamase inhibitors

- Patients who are otherwise ineligible to receive the antibiotics in this study

- Patients highly unlikely to undergo PD according to the surgeon's judgment, such as
conditions amenable to pancreas enucleation, ampullectomy, etc.

- Patients with long-term glucocorticosteroid use. The following uses of corticosteroids
are permitted: single doses, topical applications (e.g., for rash), inhaled sprays
(e.g., for obstructive airways diseases), eye drops or local injections (e.g.,
intra-articular)

- Patients unable to provide informed consent

- Creatinine clearance (CrCl)
- Patients receiving hemodialysis or peritoneal dialysis

- Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a
female after conception and until the termination of gestation, confirmed by a
positive hCG laboratory test

- Patients with a known bacterial infection present at the time of surgery or who
received antimicrobial therapy within 7 days prior to surgery