Single dose prophylactic antibiotic before surgery to prevent surgical site infection: a prospective interventional study

K. Saravanan, T. Uma Maheswari


Background: Surgical site infections (SSI) are one of the most common postoperative complications leading to increased morbidity which also an important factor of increased hospital stays and increased healthcare cost. The use of prophylactic antibiotics may benefit the patients in preventing the surgical site infection. Aim of the study was to study the single dose prophylactic antibiotic use in preventing surgical site infection in elective surgery.

Methods: Patients were included from the list of elective surgery. Patient with comorbid was excluded. The patient was handled as per NICE guideline for prevention of surgical site infection and treatment 2017. Prophylactic antibiotic injection cefuroxime 1500mg administered intravenously 30 minutes before surgery, at the site of the incision.

Results: In 110 patients included in the study, 46% of patients were in 35 to 45 years, male were higher in number. 20% of patients underwent hernioplasty followed by cholecystectomy 18.3%. 9% of SSI was recorded in this study. 4 cases in cholecystectomy, 3 cases in hernioplasty, each 1 case in appendicectomy, Hydrocele and ventral hernia mesh repair. The most common bacteria isolated from the samples were Staphylococcus aureus.

Conclusions: In uncomplicated surgeries, single dose antibiotics before 30 minutes of surgery may benefit in preventing SSI.


Antibiotic prophylaxis, Cefuroxime, Surgical site infection

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Jeong WK, Park JW, Lim SB, Choi HS, Jeong SY. Cefotetan versus conventional triple antibiotic prophylaxis in elective colorectal cancer surgery. J Korean Med Sci. 2010;25:429-34.

Platell C, Hall JC. The prevention of wound infection in patients undergoing colorectal surgery. J Hosp Infect. 2001;49:233-8.

Fujita S, Saito N, Yamada T, Takii Y, Kondo K, Ohue M, et al. Randomized, multicenter trial of antibiotic prophylaxis in elective colorectal surgery. Arc. Surg. 2007;142:657-61.

Korol E, Johnston K, Waser N, Sifakis F, Jafri HS, Lo M, et al. A systematic review of risk factors associated with surgical site infections among surgical patients. PLoS One. 2013;8(12):e83743.

Teillant A, Gandra S, Barter D, Morgan DJ, Laxminarayan R. Potential burden of antibiotic resistance on surgery and cancer chemotherapy antibiotic prophylaxis in the USA: a literature review and modelling study. Lancet Infect Dis. 2015;15(12):1429-37.

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Hospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999;20(4):250-78.

Alexander JW, Solomkin JS, Edwards MJ. Updated recommendations for control of surgical site infections. Ann Surg. 2011;253(6):1082-93.

Surgical site infections: prevention and treatment. Updated February 2017. NICE, available at: chapter/1-Guidance (Accessed 29 Dec 2018).

Hill C, Mazas F, Flamant R, Evrard J. Prophylactic cefazolin versus placebo in total hip replacement: report of a multicentre double blind randomised trial. Lancet. 1981;11;1(8224):795-6.

Classen DC, Evans RS, Pestotnik SL, Horn SD, Menlove RL, Burke JP. The timing of prophylactic administration of antibiotics and the risk of surgical wound infections. N Engl J Med. 1992 Jan 30;326(5)281-6.

Burje JF. The effective period of preventive antibiotic action in experimental incision and dermal lesions. Surgery. 1961;50:161-8.

Borade S, Syed O. Single dose antibiotic prophylaxis for prevention of surgical site infection in elective surgery. Int Sur J. 2017;5(1):27.

Jogdand S, Shinde R, Chandrakar N. Outcome of Evidence-based Allocation of Single-dose Antibiotic extended to Three-dose Antibiotic Prophylaxis in Surgical Site Infection. Int J Rec Sur Med Sci. 2017;3(2):79-84.

Shah YD, Thekdi PI, Raut S, Patel KG. Single shot versus multiple shot antibiotic therapy in patients undergoing laparoscopic surgery: our experience. Int J Res Med Sci. 2013;1:252-6.

Poon JT, Law WL, Wong IW, Ching PT, Wong LM, Fan JK, et al. Impact of laparoscopic colorectal resection on surgical site infection. Ann Surg. 2009;249:77-81.

Romy S, Eisenring MC, Bettschart V, Petignat C, Francioli P, Troillet N. Laparoscope use and surgical site infections in digestive surgery. Ann Surg. 2008;247:627-32.

Nakamura T, Mitomi H, Ihara A, Onozato W, Sato T, Ozawa H, et al. Risk factors for wound infection after surgery for colorectal cancer. World J Surg. 2008;32:1138-41.

Abraham NS, Young JM, Solomon MJ. Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg. 2004;91:1111-24.