DOI: http://dx.doi.org/10.18203/2349-2902.isj20205875

A prospective study of single dose preoperative antibiotic cover in clean elective surgical cases- a single center study

Siddhartha Gowthaman Subramaniyan, Prabhu Gunasekaran, Ramanathan Manickam

Abstract


Background: Surgical site infection (SSI) is the third most common nosocomial infections occurring worldwide, thus leading to increasing cost, mortality and morbidity. The main objective was to know the incidence of SSI in clean surgical procedures carried out in the institute of MGMCRI and to determine various pathogens causing SSI.

Methods: This was a prospective observational study done on 100 patients in Department of General Surgery in MGMCRI, Puducherry from June 2015 to August 2017 who underwent clean surgical procedure. Preoperatively single done of injection cefazolin 1gm intravenous preparation was given 30 minus before the skin incision and patient were observed and followed up meticulously for the incidence of SSI and to determine the bacterial flora in the event of SSI.

Results: In our study a total of 100 patients were included.  In our study a total of three out of 100 patients developed SSI which was around 3%.Out of the 3 patients who had SSI all were a male which is around 4.6% in our study. In relation to the distribution based on the age group more than 50 year of the age are most frequently associated with SSI in our study. The bacterial flora includes staphylococcus aureus which was isolated from one patient and Klebsiella pneumonia isolated from two patients who had surgical site infections.

Conclusions: This study concludes that single dose pre-operative antibiotic has advantage in prevention of SSI and it is cost effective for patient. 


Keywords


Antibiotics prophylaxis, Cefazolin, Surgical site infection

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References


Smyth ET, McIlvenny G, Enstone JE, Emmerson AM, Humphreys H, Fitzpatrick F, et al. Four country healthcare associated infection prevalence survey 2006: overview of the results. J Hosp Infect. 2008;69:230-48.

Lilani SP, Jangale N, Chowdhary A, Daver GB. Surgical site infection in clean and clean-contaminated cases. Indian journal of medical microbiology. 2005 Oct 1;23(4):249-52.

Department of Surgical Education, Orlando Regional Medical Center. Antibiotic prophylaxis for surgery. Treatment guidelines. Med Letter. 2004;2(20):27-32.

National Collaborating Centre for Women’s and Children’s Health (UK). Surgical Site Infection: Prevention and Treatment of Surgical Site Infection. (NICE Clinical Guidelines, No. 74.) 2. London: RCOG Press; 2008.

Roger Finch, G. Antimicrobial therapy: principles of use. Medicine, Volume 33, Issue 3, 1 March 2005, Pages 42-46.

Thejeswi PC, Shenoy D, Tauro LF, Ram SHS. Comparative study of one-day perioperative antibiotic prophylaxis versus seven-day postoperative antibiotic coverage in elective surgical cases. Internet J Surg. 2012;28(2).

Dellinger EP, Gross PA, Barrett TL, Krause PJ, Martone WJ, McGowan JE, et al. Quality standard for antimicrobial prophylaxis in surgical procedures. Clin Infect Dis. 1994;18:422-7.

Vaze D, Samujh R, Narasimha Rao KL. Risk of surgical site infection in paediatric herniotomies without any prophylactic antibiotics: A preliminary experience. Afr J Paediatr Surg. 2014;11(2):158-61.

Scheinfeld N, Struach S, Ross B. Antibiotic prophylaxis guideline awareness and antibiotic prophylaxis use among New York State dermatologic surgeons. Dermatol Surg. 2002;28:841-4.

Woods RK, Dellinger EP. Current guidelines for antibiotic prophylaxis of surgical wounds. Am Fam Phys. 1998;57:2731-40.

Chambers HF. Betalactam antibiotics and other antibiotics of cell wall synthesis. In: Katzung BG, editor. Basic Clinical Pharmacology. 8th edn. New York: Lange Medical Books, McGraw-Hill; 2001:762.

Ranjan A, Singh R, Naik PC. A comparative study of single-dose preoperative antibiotic prophylaxis versus routine long-term postoperative prophylaxis in elective general surgical cases. Int J Med Sci Public Health. 2016;5:1083-7.

Suchitra B, Lakshmidevi N. Surgical site infections: Assessing risk factors, outcomes and antimicrobial sensitivity patterns. Afr J Microbiol Res. 2009;3(4):175-9.

Kakati B, Kumar A, Gupta P, Sachan PK, Thakuria B. Surgical site abdominal wound infections: Experience at a north Indian tertiary care hospital. JIACM. 2013;14(1):13-9.

Rayamajhi B, Basukala S. A comparative study following single-dose versus three-dose perioperative antimicrobial prophylaxis in clean elective surgical cases. Innov J Med Health Sci. 2015;5(2):42-5.

Kamat US, Fereirra AM, Kulkarni MS, Motghare DD. A prospective study of surgical site infections in a teaching hospital in Goa. Indian J Surg. 2008;70(3):120.

Madhu BS, Kumar SHB, Reddy NKM, Reddy AV, Kalabhairav S. Effect of single dose pre-operative antibiotic prophylaxis versus conventional antibiotic therapy in patients undergoing lichtenstein tension free mesh repair. Int Surg J. 2017;4:738-42.

Aufenacker TJ, van Geldere D, Van Mesdag T, Bossers AN, Dekker B, Scheijde E, et al. The role of antibiotic prophylaxis in prevention of wound infection after Lichtenstein open mesh repair of primary inguinal hernia: a multicenter double-blind randomized controlled trial. Ann Surg. 2004;240(6):955.

Ahn BK, Lee KH, 1.Single-dose antibiotic prophylaxis is effective enough in colorectal surgery, ANZ J Surg. 2013 Sep;83(9):641-5.

Ali K, Latif H, Ahmad S. J Ayub Med Coll Abbottabad, 3.Frequency of wound infection in non-perforated appendicitis with use of single dose preoperative antibiotics, 2015 Apr-Jun;27(2):378-80.

MehrabiBahar M, Jabbari Nooghabi M, Jangjoo A, The role of prophylactic cefazolin in the prevention of infection after various types of abdominal wall hernia repair with mesh, Asian J Surg. 2015 Jul;38(3):139-44.