Study of prophylactic single-dose antibiotic to prevent surgical site infection
Keywords:Antibiotic prophylaxis, Surgical site infection, Surgical wound infection
Background: Surgical site infections (SSIs) have been linked to longer hospital stays and higher costs. Infection occurs when endogenous flora is translocated to a generally sterile site. It's also feasible to seed the surgical site with illness from afar (especially in patients with prostheses or another implant). SSIs are influenced by bacterial inoculums and pathogenicity, host defenses, preoperative care, and intraoperative management. Antibiotic prophylaxis is therefore essential to address this problem. This study to evaluate the effectiveness of single-dose antibiotic prophylaxis in preventing surgical site infection in elective surgeries.
Methods: This prospective study included 50 patients receiving elective surgery at a tertiary hospital's department of general surgery. Relevant information about each patient was obtained using a Performa developed for the project. Cefuroxime was given 30 minutes before the incision, and effect on post-operative wound infection was investigated.
Results: We had 50 cases in our study, predominantly males, with maximum individuals in the 41-50 years age group. Cholecystectomy cases presented with the most SSIs (20%). S. aureus was the most common causative organism of SSI in this study.
Conclusions: A single preoperative dose of antibiotic cefuroxime effectively prevents surgical site infection in elective cases assuming an uncomplicated procedure.
Fonseca S. Implementing 1-Dose Antibiotic Prophylaxis for Prevention of Surgical Site Infection. Arch Surg. 2006;141(11):1109.
Mandell ZA. Douglas, and Bennett's principles and practice of infectious diseases. The Lancet Infect Diseases. 2010;10(5):303-4.
Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ. The impact of surgical site infections in the 1990s. Infect Control Hosp Epidemiol. 1999;20(11):725-30.
Scottish Intercollegiate Guidelines Network (SIGN). Antibiotic prophylaxis in surgery. Edinburgh: SIGN; 2008. (SIGN publication no.104). Available at: http://www.sign.ac.uk. Accessed on 20 February 2021.
Berrios-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg. 2017;152:784-91.
Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. centers for disease control and prevention (CDC) hospital infection control practices advisory committee. Am J Infect Control. 1999;27:97-132.
Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect. Control Hosp. Epidemiol. 2011;32:101-14.
Cruse PJ, Foord R. The epidemiology of wound infection: a 10-year prospective study of 62,939 wounds. Surg Clin N 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. N Engl J Med. 1992;326(5):281-6.
Kaye K, Schmit K, Pieper C, Sloane R, Caughlan K, Sexton D, et al. The Effect of Increasing Age on the Risk of Surgical Site Infection. J Infect Dis. 2005;191(7):1056-62.
Dégbey C, Kpozehouen A, Coulibaly D, Chigblo P, Avakoudjo J, Ouendo E, et al. Prevalence and Factors Associated with Surgical Site Infections in the University Clinics of Traumatology and Urology of the National University Hospital Centre Hubert Koutoukou Maga in Cotonou. Frontiers in Public Health. 2021;9.
Birintanya N. Etude de la prévalence des infections des plaies postopératoires au Centre Hospitalier Départemental de l'Ouémé et Plateau. (Mémoire de Maitrise en Santé Publique). Université d'Abomey-Calavi, Institut Régional de Santé Publique, Ouidah. 2002.
Koirala K, Mukhia R, Sharma S, Manandhar S, Banepali N, Shrestha R, et al. A single-dose antibiotic prophylaxis to prevent surgical site infection in clean-contaminated surgery among diabetic patients. J Patan Academy Health Sc. 2015;1(2):8-10.
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.