Role of antibiotics in elective clean surgeries: limiting its use to single shot preoperative dose

Authors

  • P. T. Jamdade Department of General Surgery, Government Medical College, Latur, Maharashtra, India
  • Meghraj J. Chawada Department of General Surgery, Government Medical College, Latur, Maharashtra, India
  • Apurva Samant Department of General Surgery, Government Medical College, Latur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20201394

Keywords:

Antibiotic, Efficacy, Incidence, Surgery, SSI, Therapy

Abstract

Background: Conventional antibiotic therapy during operation not only increases the financial burden on patient, not only increases chances of adverse reactions among them but also not effective in reducing the infection rate after surgery. Single dose prophylactic antibiotic or maximum 24 hours dosing during or before surgery was found to be equally effective. Objective was the to study utility of single shot antibiotic prophylaxis in patients undergoing surgery

Methods: This prospective study includes 100 clean elective surgical cases randomized to groups of 50 each. Single dose prophylactic antibiotic was given to cases in the study group and conventional antibiotic therapy was given to cases in the control group. Study group cases received Injection Ceftriaxone in the dose of 2 gm intravenously. This was given at induction or half an hour before the incision was given. Second dose was given if there was delay in starting the surgery for more than three hours. Dose of the antibiotic was adjusted for children, underweight and obese persons. For cases in the control group. Injection ceftriaxone 1 gm was given intravenously twice a day for three days. Surgical site infection incidence was recorded.

Results: Both the groups were comparable for age, sex, diagnosis and hence the type of surgery performed. The incidence of fever, redness, swelling and wound discharge which are the signs of surgical site infection after surgery was not found to be statistically significantly different. Management protocol was also not significantly different after the surgery.

Conclusions: Single shot antibiotic before surgery is equally effective in reducing the incidence of surgical site infections (SSIs) compared to conventional antibiotic therapy.

References

Tarchini G, Liau KH, Solomkin JS. Antimicrobial stewardship in surgery: challenges and opportunities. Clin Infect Dis. 2017;15(64):112-4.

Dahl A, Robertsson O, Stefánsdóttir A, Gustafson P, Lidgren L. Timing of preoperative antibiotics for knee arthroplasties: improving the routines in Sweden. Patient Saf Surg. 2011;19(5):22.

Ahmed SO, Mahadi SI, Ahmed ME. Antibiotic prophylaxis in clean and clean-contaminated surgery and surgical site infection in Khartoum teaching hospital. Sudan Med J. 2015;50(3):24-32.

Chaudhary R, Sharma S, Chaudhary S, Thakur S, Shukla A, Sharma A. A prospective study comparing single with multiple antibiotic prophylaxis dose in elective cholecystectomy. Ann Int Med Den Res. 2015;1(1):29-33.

Diwaker A. A comparative study of Single dose versus multiple doses of antibiotic prophylaxis in open inguinal hernioplasty. IOSR J Dental Med Sci. 2018;17(5):28-32.

Agrawal NK, Khan MJ, Sherwani MKA, Zahid M, Ahmad S, Shukla I. Short-course perioperative antibiotic prophylaxis to prevent surgical site infection in elective orthopedic surgery. J Orthopedics Traumatol Rehab. 2018;10(1):67-70.

Mundhada AS, Tenpe S. A study of organisms causing surgical site infections and their antimicrobial susceptibility in a tertiary care government hospital. Indian J Pathol Microbiol. 2015;58(2):195-200.

Mathur P, Trikha V, Farooque K, Sharma V, Jain N, Bhardwaj N, et al. Implementation of a short course of prophylactic antibiotic treatment for prevention of postoperative infections in clean orthopaedic surgeries. Indian J Med Res. 2013;137(1):111-6.

Lovato C, Wagner JD. Infection rates following perioperative prophylactic antibiotics versus postoperative extended regimen prophylactic antibiotics in surgical management of mandibular fractures. J Oral Maxillofac Surg. 2009;67(4):827-32.

Xu SG, Mao ZG, Liu BS, Zhu HH, Pan HL. Evaluating the use of antibiotic prophylaxis during open reduction and internal fixation surgery in patients at low risk of surgical site infection. Injury. 2015;46(2):184-8.

Marimuthu C, Abraham VT, Ravichandran M, Achimuthu R. Antimicrobial prophylaxis in instrumented spinal fusion surgery: a comparative analysis of 24-hour and 72-hour dosages. Asian Spine J. 2016;10(6):1018-22.

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Published

2020-03-26

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Original Research Articles