A randomised controlled trial comparing the efficacy of single dose prophylactic ceftriaxone versus post-operative ciprofloxacin and metronidazole combination in reducing post-operative wound infection after clean surgeries

Authors

  • S. Vasu Assistant Professor, Department of General Surgery, Vydehi Institute of Medical Science and Research Centre, Bangalore, Karnataka, India
  • Kshir Sagar Professor, Department of General surgery, Sapthagiri Institute of Medical Science and Research Centre, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20184704

Keywords:

Clean surgeries, Multiple dose ciprofloxacin and metronidazole, Single dose ceftriaxone, Wound infections

Abstract

Background: Surgical site infections were considered to be the major contributor to increased morbidity and mortality in clean surgeries. Many studies prove that single dose prophylaxis is more effective than multiple dosing. No data currently exist about comparative efficacy of single dose prophylactic ceftriaxone with postoperative ciprofloxacin and metronidazole combination in reducing postoperative wound infection after clean surgeries. Hence the present study was done to compare their efficacy in terms rate of incidence of wound infection and side effects.

Methods: This prospective study was done on 120 patients who were selected for clean surgeries at Sapthagiri Institute of Medical Science and Research Centre, Bengaluru during the period from April 2015 and March 2016. 60 patients received single dose of ceftriaxone prophylactically and considered as study group and other 60 patients received combination of ciprofloxacin and metronidazole postoperatively for 5-7 days and considered as control group. The efficacy of drugs was estimated in terms of reducing the incidence of wound infection.

Results: The wound infection rate was 13.33% in the study group and 28.33% in control. Staphylococcus aureus was the most common organism isolated from wound discharge. However, gram negative organism accounted for majority of infections. There were no major side effects encountered in either of the groups.

Conclusions: The study concludes that single dose ceftriaxone can be widely applied in the routine practice in clean surgeries. The single dose ceftriaxone showed many advantages over the control group in terms of Reduced the incidence of postoperative wound infection with no major side effects.

References

Turano A. Antibiotics prophylaxis for surgical infection. Am J Surg. 1992;64(4):15.

Dietmar H, Condon ER. Surgical Infection and AIDS. Oxford text book of surgery. 2000. 2nd Edn. Volume 1. 2000:41-43.

Bal S. Estimating cost effectiveness of prophylaxis for surgical infection. Hospital Today. 1999;4(7):341-3.

Nichols RL. Current Strategies for Prevention of Surgical Site Infections. Curr Infect Dis Rep. 2004;6:426-34.

Pollock AV. A review of Amoxycillin clavulanic acid in surgical prophylaxis. Eur J Obst Gynec Rep Biol. 1994;90(2):141-5.

Setiawan B. The role of prophylactic antibiotics in preventing perioperative infection. Acta Med Indones. 2011;43(4):262-6.

Auerbach AD. Prevention of surgical site infections. In: Shojania KG, Duncan BW, McDonald KM et al., eds. Making Health Care Safer: A Critical Analysis of Patient Safety Practices. Evidence Report/Technology Assessment No. 43. Rockville, MD: AHRQ Publication. 2001: 221-244.

Jones RN, Wojeski W, Bakke J, Porter C, Searles M. Antibiotic prophylaxis of 1,036 patients undergoing elective surgical procedures. A prospective, randomized comparative trial of cefazolin, cefoxitin, and cefotaxime in a prepaid medical practice. Am J Surg. 1987;153(4):341-6.

Burke JF. The effective period of preventive antibiotic action in experimental incisions and dermal lesions. Surgery. 1961;50:161-8.

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 Eng J Med. 1992;326:281-6.

Lippert H, Gastinger J. Antimicrobial prophylaxis in Laparoscopic and conventional cholecystectomy. Chemotherapy. 1998;44:355-63.

Bunn F, Cunningham ME, Handscomb K. Prophylactic antibiotics to prevent surgical site infection afterbreast cancer surgery (Review). Cochrane Database of Systematic Reviews. 2006;(2):CD005360.

Nooyen SM, Overbeek BP, Brutel de la Riviere A, Storm AJ, Langemeyer JM. Prospective randomised comparison of single-dose versus multiple-dose cefuroxime for prophylaxis in coronary artery bypass grafting. Eur J Clin Microbiol Infect Dis. 1994;13:1033-7.

Schaberg DR. Resistant gram-positive organisms. Aim Emerg Med. 1994;24(3):462-4.

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. International J Medical Sci Public Health. 2016;5(6):1083-7.

Downloads

Published

2018-11-28

Issue

Section

Original Research Articles