Published: 2021-12-28

Comparison of single dose versus multiple doses of antibiotic prophylaxis for prevention of surgical site infection

Swapan Das, Rajib Kundu, Bani Prasad Chattopadhyay


Background: Surgical site infection is a common problem following general surgical procedures. Despite major improvement in antibiotics, improved antiseptic measures SSI continues to present a big challenge. In this study we will compare single dose versus multiple dose antibiotic prophylaxis for prevention of SSI in clean and clean contaminated surgical wound.

Methods: This is an institution based prospective, comparative study, with total 60 patients as study population. Clinical finding, wound swab culture and routine haematological reports were taken as study variables. Patients receiving single dose antibiotic and multiple dose antibiotic were included in ‘Group A’ and ‘Group B’ respectively. The surgical sites were examined from post-operative days 3 to 8 for signs of infection.

Results: In This study, 46.7% patients were female, and 53.3% patients were male. In Group-A, patients having post operative fever, tachycardia and leucocytosis were 16.7%, 13.3% and 20.0% respectively. 6.7% patients had purulent and 10.0% patients had seropurulent discharge from wound. In Group-B, patients having post operative fever, tachycardia, and leucocytosis were 13.3%, 16.7% and 13.3% respectively. 6.7% patients had purulent and seropurulent discharge from wound. There is no statistically significant difference between two groups regarding post operative fever, tachycardia, leucocytosis and wound discharge.

Conclusions: There is no significant difference between single dose and multiple dose antibiotic prophylaxis to prevent SSI in patients for elective clean and clean contaminated surgery however single dose is more cost effective.


Antibiotic prophylaxis, Single dose versus multiple doses, Surgical site infection

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Berríos-Torres SI, Umscheid CA, Bratzler DW. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. 2017;152:784.

April 2013 CDC/NHSN Protocol Corrections, Clarification, and Additions. Available at: Accessed on July 10 2013.

Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project: Statistics on hospital stays. 2013. Available at: Accessed on July 27 2016.

Scott RD. The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. CDC, Atlanta 2009. Available at: scott_costpaper.pdf. Accessed on July 27, 2016.

Kulayat MN, Dayton MT. In: Sabiston Textbook Of Surgery. Townsend CM, Jr, Beauchamp RD, Evers MB, Mattox KL, eds. Volume 1. First south asia edition. Elsevier. 2016:284-7.

Berrios-Torres SI. Evidence-based update to the U.S. Centers for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee guideline for the prevention of surgical site infection: developmental process. Surg Infect (Larchmt). 2016;17:256-61.

Misra AK, Gupta R, Bedi JS, Narang S, Garg S, Mail I. Antibiotic prophylaxis for surgical site infection: need of time. Health. 2015;3:3.

Shaikh SA, Iqbal M. Comparison of Single Dose with Multiple Dose Antibiotic Prophylaxis with Cefuroxime in Open Cholecystectomy. Journal of Islamabad Medical & Dental College. 2012;1(1):2-5.

Shah YD, Thekdi PI, Raut S, Patel KG. Single shot versus multiple shot antibiotic therapy in patients undergoing laparoscopic surgery: their experience. Int J Res Med Sci. 2013;1(5):252-6.

Rahman MM, Rahman MM, Munim MI, Haque MS. Role of Single Dose Preoperative Ceftriaxone in the Control of Surgical Site Infection in a Tertiary Level Hospital. Faridpur Medical College Journal. 2016;11(1):6-10.

Pinto‐Lopes R, Sousa‐Pinto B, Azevedo LF. Single dose versus multiple dose of antibiotic prophylaxis in caesarean section: a systematic review and meta‐analysis. BJOG: An International Journal of Obstetrics & Gynaecology. 2017;124(4):595- 605.

Bhatnagar N, Sural S, Arora S, Lingaiah P, Dhal A. Efficacy of single dose versus multiple dose injectable antibiotics in hip joint surgery. Journal of Orthopaedics Trauma Surgery and Related Research. 2017;12(2).

Frank M, Francis J, Bender M, Roberts M, Watson D, Shah A et al. Multidose prophylactic IV antibiotics do not lower the risk of surgical site infection for isolated closed ankle fractures. Ota International. 2019;2(4):e035.