A prospective blinded randomized controlled trial of use of preoperative antibiotics in routine abdominal surgery: A comparison between single dose versus three doses between Ofloxacin + Metronidazole and Cefotaxime + Sulbactum
Keywords:
Postoperative, Surgical site infections, AntibioticsAbstract
Introduction: Anti microbial prophylaxis before any elective surgery is preferred deterrent post operative surgical site infection now. Many regimes with different antimicrobial agents are tried and most institutions have developed their own regime or philosophy to address postoperative surgical site infection. We have also our own antibiotic prophylaxis and protocol. Method: A total of 138 patients (above 16 years) were taken for study. It was randomized and blind study. Patients were prospectively analysed. First, patients were divided into two groups. Those who have received single dose antibiotic at incision and those who received two more doses after first dose. Open elective as well as laparoscopic elective procedures have included study. Routine practice of preoperative bath, preoperative preparations of the area with iodophores and spirit, operating under normothermia and hydration were as per institutional philosophy and common to all the patients. Two combinations compared: Cefotaxime+ Sulbactum & Ofloxacin + Metronidazole. Keeping outcome of study in mind all materials were analysed and statistical analysis done and confidence intervals were noted. Results: Study revealed interesting observations. Single dose pre operative prophylaxis scored over three doses regime in all cases for lap surgery. Conclusion: Multiday and antibiotics use for prolonged period is not advisable these days after a routine elective abdominal surgery.
References
Alicia J et al. Guidelines for prevention of surgical site infection. American Journal of Infection Control 1999 April; 27:100
Auerbach AD. Prevention of Surgical Site infection. Agency for healthcare Research and Quality 2001:221- 44.
Nigel Mark Bagnall et al. Surgical site infection. Surgery, 1991; 27(10):426-30
Mangram AJ et al. Guideline for prevention of Surgical site infection, Infect Control Hosp Epidemiol 199; 20:247-80
Mandell GL et al,Douglas and Bennett’s Principles and practice of infectious diseases. 6th. EditionNew York:Elsevier/Churchill Livingstone, 2005
Dellinger EP et al, Quality standard for antimicrobial prophylaxis in surgical procedures. Infectious diseases society of America. Clinical infectious disease, 1994; 18:422-27
Page CP et al, Antimicrobial prophylaxis for surgical wounds. Guidelines for clinical care. Archives of Surgery, 1993; 128:79-88
Meijer WS, Schmitz P et al. Meta-analysis of Randomized controlled clical trials of antibiotics prophylaxis in biliary tract surgery. British Journal of Surgery 1990; 77: 283-90
Joseph T et al. Single dose systemic antibiotics prophylaxis of surgical wound infection. American Journal of Surgery 1996; 152(5): 552-59
Platell C et al. The prevention of wound infection in surgical patients undergoing colorectal surgery J. Hosp. Infect 2001; 49:233-38
Dimick JB et al. Hospital costs associated with surgical complications: A report from the Private-sector National surgical quality improvement program. J Am Col Surg. 2004; 199:531-37
Kirkland KB et al. The impact of surgical site infections in the 1990 s: Attributable mortality, excess length of hospitalization and extra costs. Infect control hosp epidemiol. 199; 20: 725-30
Fiona Burton. Preventing surgical site infections. Wound essentials 2007; 2:124-31
Coello R et al. Adverse impact of surgical site infections in English hospitals. Journal of hospital infection 2005; 60:93-103
Kable AK et al. Adverse events in surgical patients in Australia. International journal of quality in healthcare 2002; 14:269-76
Rioux C et al. The standardized incidence ratio as a reliable tool for surgical site infection surveillance. Infection control and Hospital epidemiology 2006; 27:817-24
Nguyen D et al. Incidence and predictors of surgical site infections in Vietnam. Infection control and Hospital epidemiology 2001; 22:485-92
Moro ML et al. Rates of surgical sites infection: An international comparison. Infection control and Hospital epidemiology 2005; 26:442-48
Freeman, C.D., Klutman, N.E., and Lamp, K.C. Metronidazole: A therapeutic review and update. Drugs, 1997, 54:679-708.
Karchmer, A.W. Cephalosporins. In, Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 5th ed. (Mandell, G.L., Bennett, J.E., and Dolin, R., Eds.) Churchill Livingstone, Philadelphia, 2000, pp. 274-291.
Bryson, H.M., and Brogden, R.N. Piperacillin/tazobactam: A review of its antibacterial activity, pharmacokinetic properties and therapeutic potential. Drugs, 1994, 47:506-535.
Eliopoulos, G.M., and Eliopoulos, C.T. Activity in vitro of the quinolones. In, Quinolone Antimicrobial Agents, 2d ed. (Hooper, D.C., and Wolfson, J.S., Eds.) American Society for Microbiology, Washington, 1993, pp. 161-193.
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Biomedical Review follows the Creative Commons CC-BY license (Attribution). It means Authors can use, reuse and build upon the material published in the journal but only for non-commercial purposes. Every article published in the Journal clearly mentioned licensing terms between author/authors and publisher (Siddharth Health Research and Social Welfare Society) as the logo of Creative Commons CC-BY license (Attribution) https://creativecommons.org/licenses/by/4.0/.