Effect of single dose pre-operative antibiotic prophylaxis versus conventional antibiotic therapy in patients undergoing lichtenstein tension free mesh repair
DOI:
https://doi.org/10.18203/2349-2902.isj20170224Keywords:
Antibiotics, Conventional therapy, Cost effective, MESH repair, Prophylaxis, Surgical site infectionAbstract
Background: Rational use of antibiotic is important as injudicious use can adversely affect the patient, cause emergence of antibiotic resistance and increase the cost of health care. The efficacy of antibiotic prophylaxis in preventing surgical site infection in patients undergoing Lichtenstein tension free inguinal hernia repair still remains controversial.
Methods: A randomized controlled trial was conducted in patients undergoing lichtenstein tension free inguinal hernia repair between January 2015 to June 2016, and the results were compared with the control group in whom, conventional antibiotics were given for 7 days . All patients in study group undergoing surgery were given 400 mg parenteral ciprofloxacin 30 min prior to surgery. In the control group, the patients were given 2 days parenteral ciprofloxacin 400 mg twice a day and the next 5 days the same antibiotics were given in oral route, after surgery. Total 100 patients were randomized to 50 each group. The outcome in terms of duration of surgery, surgical site infection, cost and antibiotic side effects were then compared.
Results: The duration of the hospital stay, cost and side effects are significantly higher in the control group patients. Antibiotic side effects (P < 0.05) were high for control group. The infection rate was same in both the groups. There was no significant difference in terms of infection rate among two groups.
Conclusions: This study concludes that prophylactic single-dose antibiotic is effective in preventing surgical site infection and is cost-effective in patients undergoing lichtenstein tension free mesh repair.
References
Gudiol F. Surgical antibiotic prophylaxis tradition and change. Int J Clin Pract. 1998;95(1):398-438.
Kass EH. Antimicrobial drug usage in general hospitals in Pennsylvania. Ann Int Med. 1976;89:802-5.
Lim VKE, Cheong YM, Suleiman AB. Pattern of antibiotic usage in hospitals in Malaysia. Singapore Med J. 1993;34:525-8.
WHO-Surveillance of Antimicrobial resistance. Available from: http:// www.who.int /drugresistance /surveillance/en. Accessed on 12 July 2016.
Esposito S. Is single dose antibiotic prophylaxis sufficient for any surgical procedure? 1999;2:556-4.
Bonal J, Castro I, Farre R, Saura R, Perez JM. Programme d' amelioration de la qualite de la prophylaxie chirurgicale antibiotique. Le pharmacie Hospitalier. 1996;31(124):25-7.
Avery CME, Jemienson N, Caine RY. Effective administration of heparin and antibiotic prophylaxis. Br J Surg 1995;82:1136-7.
Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70:195-283.
Bernard HR, Cole WR. The prophylaxis of surgical infection, the effect of prophylactic antimicrobial drugs on the incidence of infection following potentially contaminated operation. Surgery. 1964;56:151-7.
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.
Chambers HF. Betalactam antibiotics and other antibiotics of cell wall synthesis. In: Katzung BG, editor. Basic Clinical Pharmacology. 8th ed. New York: Lange Medical Books, McGraw-Hill. 2001:762.
Naz MZ. A comparative study between a single dosecephradine as a prophylaxis versus conventional dose antibiotic in major gynecological procedure in SSMC and MH. Dissertation for FCPS, BCPS, Mohakhali. Dhaka, 2001.
Wideman GL, Matthijssen C. Comparative efficacy of cefotaxime and cefazolin as prophylaxis against infections following elective hysterectomy. Clin Ther. 1982;5:67-73.
Woods RK, Dellinger EP. Current guidelines for antibiotic prophylaxis of surgical wounds. Am Fam Physician. 1998;57:2731-40.
Arjona FM, Cabrera HR, Sancha GF, Nieto S, Calero RJ. Economical saving due to prophylaxis in the prevention of surgical wound infection. Eur J Epidemiol. 1996;12:455-9.