Role of prophylactic antibiotics in elective surgeries and postoperative surgical infections
DOI:
https://doi.org/10.18203/2349-2902.isj20202822Keywords:
Asepsis, Health care associated infections, Prophylaxis, Single dose antibiotic, Surgical site infectionAbstract
Background: Health care associated infections (HAIs) present a significant source of preventable morbidity and mortality. More than 30% of all HAIS are represented by surgical site infections (SSIs) making them most common sub types between 1.9% and 2.7% of all surgical patients. Joseph Lister “the man who made surgery safe” introduced antiseptic method for safe surgeries. As many are now considering antibiotics “wonder drug” which covers the surgical techniques and having asepsis. Extensive indiscriminate use of antibiotics has resulted in developing resistance.
Methods: Study conducted in about 100 cases in various surgical units having various surgical procedures. Only clean cases are taken. A single stat dose of first generation cephalosporin 1gm given IV at the time of giving anesthesia. Postoperative any signs and symptoms like infections, fever with chills, wound discharge are observed. If any evidence of wound infection is present, accordingly sent for culture and sensitivity and suitable antibiotics are given.
Results: In our study 5 patients had fever with serous discharge 2 patients showed no growth, 3 patients had got growth positive (2- staphylococcus aurous, 1- pseudomonas). Hence our infection rate is 3%.
Conclusions: Single dose prophylaxis has got definite advantage to overcome the postoperative wound sepsis. Prolonged antibiotic therapy should be avoided as it has got no added advantages over single dose antibiotic.
References
CDC/NHSN protocol corrections, clarification, and additions. Available at http://www.cdc.gov/ nhsn/PDFs/pscManual/9pscSSIcurrent.pdf. Accessed on 12 January 2020.
Magill SS, Hellinger W, Cohen J. Prevalence of healthcare-associated infections in acute care hospitals in Jacksonville, Florida. Infect Control Hosp Epidemiol. 2012:33(3):283-91.
Meeks DW, Lally KP, Carrick MM. Compliance with guidelines to prevent surgical site infections. Am J Surg. 2011;201:76-83.
CDC. Data from the National Hospital Discharge Survey 2010. Available at http:// www.cdc.gov/ nchs/data/nhds/4procedures/2010pro_numberpercentage.pdf. Accessed on 12 January 2020.
Mu Y, Edwards JR, Horan TC. Improving risks-adjusted measures of surgical site infections for the national healthcare safety network. Infect Control Hosp Epidemiol. 2011;32(10): 970-86.
Klevens RM, Edwards JR, Richards CL. Estimating health care-associated infections and deaths in U.S. hospitals. Public Health Rep. 2007;122(2):160-6.
Hawn M, Vick CC, Richman J. Surgical site infection prevention. Ann Surg. 2011;8:494-501.
Anthony T, Murray B, Ping W. Evaluating an evidence-based bundle for preventing surgical site infection: a randomised trial. Arch Surg. 2011;146(3):263-9.
Jone P. Antibiotic prophylaxis of 1036 patients undergoing elective surgical procedure. Am J Surg. 1987;153:343-5.
Wong A, Beringer V. Influence of timing of antibiotic administration of tissue concentration during surgery. Am J Surg. 1995;169:379-81.
Hiram C, Polk JR, David H, Culver G. Surgical wound infection rate by wound class, operative procedure and patients risk index. Am J Med. 1991;91:152-8.
Garcia ML. Risk factor for surgical wound infection in general surgery a prospective study. Infect Control Hosp Epidemiol. 1997;18:310-5.
Lopez P, Major K. Postoperative wound infection a prospective study of determiner factor and prevention. Surgery. 1969;66:97-103.
Gyssens IC. Preventing postoperative infections. Drugs. 1999;57(2):175-85.
Stone J. Antibiotic prophylaxis in gastric biliary and colonic surgery. Ann Surgery. 1976;184:443-53.
Haynes AB, Weiser TG, Berry WR. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360:491-9.
Vries EN, Dijkstra L, Smorenburg SM. The surgical patient safety system (SURPASS) checklist optimizes timing of antibiotic prophylaxis. Patient Saf Surg. 2010;4:6.
Webster J. Preoperatively bathing or showering with skin antiseptic to prevent surgical site infection. Cochrane Database Sys Rev. 2007;2:CD004985.
Tanner J, Woodings D, Moncaster K. Preoperative hair removal to reduce surgical site infection. Cochrane Database Sys Rev. 2006;3:CD004122.
Tanner J, Swarbrook S, Stuart J. Surgical hand antisepsis to reduce surgical site infection. Cochrane Database Sys Rev. 2008;1:CD004288.
Dalfino L, Giglio MT, Puntillo F. Haemodynamic goal-directed therapy and postoperative infection; earlier is better. a systemic review and meta-analysis. Crit Care. 2011;15(3):154.
Cruse PJ, Foord R. The epidemiology of wound infection: a 10-year prospective study of 62,939 wounds. Surg Clin North Am. 1980;60(1):27-40.
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 infection. New England J Med. 1992;326(5):281-6.
Anvikar AR, Deshmukh AB, Karyakarte RP, Damle AS, Patwardhan NS, Malik AK, et al. A one-year prospective study of 3280 surgical wounds. Indian J Medical Microbiol. 1999;17(3):129-32.
Olson MM, Lee JT. Continuous, 10-year wound infection surveillance. Results, advantages, and unanswered questions. Arch Surg. 1990;125:794-803.
