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Antibiotic Prophylaxis in Surgery is Adherence to Standard Guildlines Feasible in a Tertiary Centre of Developing Country

Caren Dsouza, Associate Professor, Department of General, Father Muller Medical College, Kankanady, Karnataka 575002, India. , Caren Dsouzaa , Sudhirb , Erel Diazc , Prashanthd , Lucindae , Steffyf

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New Indian Journal of Surgery 9(2):p 146-150, March - April 2018. | DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9218.6

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Abstract

 Introduction: Antibiotic use in various surgical procedures should be decided by the surgeon based on the type of case, the duration of surgery, and various patient and environmental related factors. However there has been non judicious usage of antibiotics which has inturn propelled the emergence of antibiotic resistancee and spiralled the treatment cost in hospitals. Hence this study aims to compare  the efficacy of single dose antibiotic usage in our hospital in comparison with conventional antibiotic usage.

Materials and Methods: A randomized control trial was done in fr mullers medical college in the surgical unit. All patients in the study group received single dose antibiotic at the time of induction of anaesthesia. The antibiotic was repeated only if the duration exceeded the half life of the antibiotic . Drains were removed in 24 hrs if found less than 70 ml. The control group patients received one dose of antibiotic at induction of anaesthesia and two doses post operatively. The outcome was assessed in terms of surgical site infection and cost of antibiotics.

Results: In the single dose regimen , 60 cases were clean and infection found in 6.6 % of the patients. 15 patients in group A underwent clean contaminated surgery and were not associated with any infection. The group B patients included 62 patients in the clean surgery category with a infection found in 8.06% of the patients. 18 patients were in the clean contaminated category of group B with no infection reported in this category. The mean duration of surgical time was seen to be higher with 3 dose regimen (67.37 min) as compared to single dose (62.8 min) though the difference was not statistically significant. The overall proportion of infection in our study was higher with group B (6.25%) as compared to single dose (5.33%). The cost of antibiotic in the group A patients was lesser than group b patients.

Conclusion: we found no statistically significant difference in the surgical site infection rate between the single or the three dose group of patients.

 

 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9218.6

Keywords

Antibiotic; Surgical Site Infection; Surgical Prophylaxis.

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